Chronic inflammatory demyelinating polyneuropathy

Question 1

___ myelinate peripheral nerves, ___ myelinate central nerves

Answer 1

Schwann cells myelinate peripheral nerves, oligodendrocytes myelinate central nerves

Question 2

Chronic inflammatory demyelinating polyneuropathy

Answer 2

• Acquired peripheral neuropathy that may onset at any age
• At onset, symptoms are a generalized pattern of numbness and weakness in the upper and lower extremities, as well as spontaneous pain that develops gradually over several weeks
  
  • May involve sensory ataxia and/or motor deficits
• Pattern involves both proximal and distal extremities and is usually symmetric
• May be progressive or relapsing-remitting
• Often misdiagnosed as Guillian-Barre syndrome or acute inflamatory demyelinating polyneuropathy
• Pathology: Patchy demyelination and edema with variable infiltrates of T cells and macrophages
• Diagnosis: EMG/NCV, CSF examination. Definitive with nerve biopsy
• Treatment: Corticosteroids, IVIG, plasma exchange, immunosuppression. Physical therapy.

Question 3

CSF findings in CIDP

Answer 3

• Increased protein
• <10 cells/mm³
• Cytoalbuminologic dissociation
  
  • Note: Also seen in GBS

Question 4

Which patients tend to present with relapsing-remitting CIDP?

Answer 4

Younger patients

Question 5

Can cranial nerves be involved in CIDP?

Answer 5

YES!

Absolutely.

Question 6

Pseudotumor cerebri and CIDP

Answer 6

Pseudotumor cerebri may be induced by the high CSF protein levels in CIDP

Question 7

Antibodies present in CIDP

Answer 7

• Anti-GM1 antibodies
• As in GBS!