Factors Influencing the Diagnosis of Chronic Inflammatory Demyelinating

Abstract

BACKGROUND: Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a neurological disorder that leads to demyelination of peripheral nerves presenting with an array of symptoms. Symptoms of CIDP include but are not limited to loss of sensation, loss of reflexes, tingling and pain, and weakness. European Federation Neurological Society (EFNS) has developed guidelines for the diagnosis of this disorder. The objective of this study is to look at the relationship between the EFNS diagnostic criteria and whether patients that have the diagnosis of CIDP met this criteria. Data collection was completed on the patients diagnosed with CIDP and then the patients that were diagnosed but did not meet the criteria were analyzed to see what common outliers exist that led to the diagnosis.   RESULTS: A total of 20 patients (13 males and 7 females) were included in the study. Eighty-three percent of patients that were correctly diagnosed using the EFNS/PNS guidelines displayed hyporeflexia at the time of their diagnosis. A large majority of the patients (83%) correctly diagnosed using the EFNS/PNS guidelines displayed distal weakness at the time of their diagnosis. At the time of their diagnosis, EMG showed that majority of those who did not meet the EFNS/PNS criteria had no nerves that displayed increased latency. Fifty-eight percent of those who did meet the criteria outlined by the EFNS/PNS guidelines had two or more nerves that presented with increased latency. Testing the velocity of patients displayed that all of the patients that did not meet the EFNS/PNS criteria did not present with nerves that had diminished velocity.   CONCLUSION: CIDP misdiagnosis continues to be an issue leading to mismanagement of these patients. This study showed a preference of the clinical component for diagnosis of CIDP even if electrophysiological criteria was not met.