CIDP, whose full name is chronic inflammatory demyelinating polyradiculoneuropathy, is a disease that affects the peripheral nerves.

The immune system normally protects the body from foreign substances by producing antibodies. In CIDP, for reasons that are not understood, antibodies mistake peripheral nerve myelin as a foreign substance and begin attacking it.

The peripheral nerves consist of nerve fibers, or axons, bundled within the protective myelin sheath. All of the fibers that travel along peripheral nerves begin and end somewhere else in the body. Among other things, they carry electrical signals, or impulses, that trigger muscle movement.

The peripheral nervous system has two divisions. The autonomic division controls automatic activities such as heart rate, and the somatic division controls movement and sensation. Symptoms of CIDP arise when the somatic nerves send no information or false information to the brain.

Symptoms of CIDP are usually symmetrical. This means that both sides of the body are equally affected. Unlike some neuropathies, or nerve disorders, in which the longest nerves are affected first, with symptoms starting in the feet, CIDP may affect long and short nerves alike. Weakness and numbness may occur in the legs and arms. However, nerves in the head are rarely affected.

The severity of symptoms depends on the amount of damage to the myelin around the nerve cell and to the cell itself, so the severity of symptoms varies from one patient to another. Likewise, the rate at which symptoms progress can vary for each patient.

CIDP is a chronic disease. Therefore, symptoms must continue to worsen for several months before a diagnosis of CIDP is firm. In many patients, symptoms may worsen for several months before leveling off and/or improving.

Many patients report that numbness and tingling are worse at night. This is probably because distractions during the day keep patients from noticing these symptoms.

Sensory nerves. The sensory nerves relay information about pressure, touch, temperature, and pain. When CIDP affects these nerves, no signals or false signals are sent to the brain. The brain interprets "no signals" as "no feeling" and cannot determine whether the affected part of the body is being touched. The brain interprets false information as sensations such as tingling, pain, or numbness.

Patients often report a sensation of numbness and tingling (pins and needles) in the extremities. Some experience a general discomfort in the feet and hands but have difficulty precisely defining it. Burning and aching pain may also be among the symptoms of CIDP.

Motor nerves. Muscles must receive a message from the motor nerves in order to function properly. In CIDP, this message is either weak or absent, resulting in muscle weakness.

When the muscles of the feet and ankles are affected, there is a tendency for the foot to drop or drag. Patients may have difficulty gripping things if the disease affects the hands. When the motor nerves do not properly reach proximal muscles close to the torso, patients have difficulty lifting their arms and legs.

As the disease progresses, patients can have trouble with mobility. Some may need to use a cane, or even a walker or wheelchair, to prevent the risk of falling. Weakness rarely limits mobility so much that a patient is confined to bed.

When the muscle is not active, it decreases in size or mass, a condition known as muscle atrophy. Some patients with CIDP experience mild muscle atrophy.

When muscle responses are weak, muscular activities require extra effort. Consequently, patients with CIDP may frequently experience fatigue.

In addition to your medical treatment, getting some regular exercise will help strengthen your muscles and minimize weakness. Be sure to take rest periods to avoid debilitating fatigue. You may also want to talk with your doctor about ways to reduce stress and tension that can exacerbate symptoms of CIDP. This, in turn, can increase your overall sense of well-being.

First published April 1, 2000
Copyright © 2000 Accordant Health Services, Inc. All Rights Reserved.

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