Chronic polyradiculoneuropathy

Chronic polyradiculoneuropathy, also known as chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), is an acquired immune-mediated disorder affecting the peripheral nervous system. It is characterized by progressive or relapsing-remitting weakness and impaired sensory function in the legs and arms, caused by damage to the myelin sheath (the protective covering of peripheral nerves) and sometimes the nerve axons themselves. The condition affects both the nerve roots (radiculopathy) and peripheral nerves (neuropathy), leading to symmetric proximal and distal muscle weakness, reduced or absent deep tendon reflexes, sensory loss (including numbness, tingling, and impaired proprioception), fatigue, and sometimes neuropathic pain. Symptoms typically develop over at least eight weeks, which distinguishes CIDP from the more acute Guillain-Barré syndrome. The disease primarily affects the peripheral nervous system, including motor and sensory nerves throughout the body. Patients may experience difficulty walking, impaired fine motor skills, and balance problems. Electrodiagnostic studies typically reveal evidence of demyelination, including prolonged distal latencies, reduced nerve conduction velocities, conduction block, and temporal dispersion. Cerebrospinal fluid analysis often shows elevated protein levels without significant pleocytosis (albuminocytologic dissociation). Nerve biopsy, when performed, may demonstrate segmental demyelination and inflammatory infiltrates. Treatment options for chronic polyradiculoneuropathy include first-line therapies such as intravenous immunoglobulin (IVIg), subcutaneous immunoglobulin, corticosteroids, and plasma exchange (plasmapheresis). Many patients respond well to these immunomodulatory treatments, though relapses are common and long-term maintenance therapy is frequently required. For refractory cases, immunosuppressive agents such as azathioprine, mycophenolate mofetil, cyclophosphamide, or rituximab may be considered. Physical therapy and rehabilitation play an important supportive role in maintaining function and quality of life. The clinical course is variable, with some patients achieving sustained remission while others experience a chronic progressive or relapsing course.

Data sourced from FDA regulatory filings and ClinicalTrials.gov. Updated periodically.

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