From the Research
Chronic inflammatory demyelinating polyneuropathy (CIDP) is diagnosed through a combination of clinical evaluation, electrodiagnostic testing, and laboratory studies, with the most recent and highest quality criteria published by the European Academy of Neurology / Peripheral Nerve Society (EAN/PNS) in 2021, as referenced in the 2022 study 1. The diagnosis begins with a thorough neurological examination to identify characteristic symptoms such as:
- Progressive weakness
- Sensory abnormalities
- Diminished or absent reflexes in multiple limbs Nerve conduction studies and electromyography (EMG) are essential diagnostic tools that typically show evidence of demyelination, including:
- Slowed nerve conduction velocities
- Conduction blocks
- Temporal dispersion
- Prolonged distal latencies in multiple nerves Cerebrospinal fluid analysis often reveals elevated protein levels without significant increase in white blood cells, known as albuminocytologic dissociation, as noted in the 2018 study 2. Blood tests are performed to rule out other conditions that can mimic CIDP, such as:
- Diabetes
- Vitamin deficiencies
- Paraproteinemias
- Infectious causes In some cases, nerve biopsy may be necessary to confirm the diagnosis, showing evidence of demyelination, remyelination, and inflammatory infiltrates, as mentioned in the 2015 study 3. MRI of nerve roots and plexuses may show nerve root enlargement or enhancement, as discussed in the 2019 study 4. The diagnosis of CIDP relies on meeting established clinical and electrodiagnostic criteria, as no single test can definitively confirm the condition, and the 2020 study 5 highlights the importance of early diagnosis and treatment to prevent irreversible disability. The 2022 study 1 emphasizes the importance of objectification of treatment response and the use of strength impairment and disability outcomes in clinical practice to interpret response to treatment and confirm the diagnosis.