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Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

Overview

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a rare acquired autoimmune neuropathy affecting the peripheral nerves (those outside the brain and spinal cord that control movement and sensation). Sometimes, it occurs secondary to infections or vaccination, when the body recognises self-proteins as foreign and forms antibodies against them. As a result, the myelin sheath around the nerves gets damaged, ultimately leading to neuronal loss.

There are different forms of CIDP depending on the nerves involved:

  • Sensory CIDP: Mainly affects feeling and sensation.
  • Multifocal CIDP (Lewis Sumner syndrome): Affects different nerves in multiple areas.
  • Motor CIDP: Mainly affects muscle strength and movement.
  • CISP (Chronic immune sensory polyradiculopathy): A rare form that affects sensory roots of nerves.
  • Distal CIDP (DADS): Symptoms mainly start in the hands and feet.

CIDP symptoms usually develop slowly over weeks to months and may fluctuate:

  • Muscle weakness, which is subacute in onset and sometimes waxes and wanes
  • Numbness of hands and feet
  • Sensory loss
  • Imbalance or unsteady walking
  • Bilaterally symmetrical symptoms (appear on both sides of the body)

CIDP is caused by an abnormal immune response, where the body’s defence system mistakenly attacks the nerves’ protective covering (myelin sheath). This damages nerve signals and, if untreated, may lead to nerve fibre loss.

Some factors may increase the likelihood of developing CIDP:

  • Age between 40 and 60 years
  • Male sex
  • Uncontrolled type 2 diabetes
  • Infections such as HIV, hepatitis B, and Epstein-Barr infections
  • Acute illnesses, vaccinations, and surgery can trigger CIDP

Doctors use a combination of tests to confirm CIDP:

  • Clinical examination: checking strength, reflexes, and sensation.
  • Nerve conduction studies: show slowing of nerve conduction in CIDP
  • Blood tests: for checking antibodies and inflammatory markers
  • Sometimes, additional tests like lumbar puncture or nerve biopsy may be recommended.

Although there is no permanent cure, treatments can significantly control symptoms and prevent progression:

  • Corticosteroids to reduce inflammation
  • Immunomodulation by drugs like azathioprine, cyclophosphamide, IvIg (intravenous immunoglobulin), Rituximab, and plasmapheresis to calm the immune attack.
  • Physical therapy and rehabilitation to maintain strength and mobility.

Seek medical advice if you notice:

  • Gradual muscle weakness or numbness in both arms or legs.
  • Increasing imbalance, frequent tripping, or falls.

There is no known way to completely prevent CIDP. However:

  • Controlling diabetes may reduce risk.
  • Regular medical follow-up after infections or surgeries can help with early detection.

People with suspected CIDP should consult a Neurologist for diagnosis and long-term management.

Disclaimer:

The information in this Health Library is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare professional with any questions about a medical condition or before starting any treatment. Use of this site and its content does not establish a doctor–patient relationship. In case of a medical emergency, call your local emergency number or visit the nearest emergency facility immediately.