Transcript
Clinical features that differentiate CIDP
Eduardo Nobile-Orazio provides practical tips to ensure accurate differentiation between various neurological disorders and CIDP variants in the clinical setting. View transcript.
Eduardo Nobile-Orazio, MD, PhD
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I think that the most important things is to listen to the patients and to making the right question, asking them. Sometimes you have patient who say, you know, "I came to the emergency room "because I'm not able to walk," you know, in the first. "But did you start already?" "yeah, well, actually I have to say that "starting already four months ago, "I start to have some weakness but I didn't pay attention "so I didn't look." So that is the first things that you have. Second, you know, not many patient has pain but they have numbness, a loss of sensation, weakness, difficulty in walking, sometimes difficulty in running.
So it's a super acuteness of the disease that make it because most other neuropathy where you deal with you know, diabetic neuropathy or other neuropathy, maybe in diabetic neuropathy you have more pain than in CIDP. Rather, they are more painful and they're more chronic it takes, you know. So there is not a specialty by seeing the patient, I make the diagnosis. You have to listen to the story, talk to the patient and visiting the patient. And when you visiting the patient, you find that he have loss of loss of reflex and that he has weakness, that he is also weak in his arm and not adjusting the forearm, you know. That is something that should raise your attention on this.
And there is also, you know, something which may be more difficult. You know, patient who has just pure motor neuropathy, pure motor CIDP, these are even more difficult because they have just motor. But also in this case you expect that this patient has more widespread, you know, distribution. This patient do not have cramp. Sometimes there is differential diagnosis with motor neuron disease, but that is a different presentation and the reflex, usually motor neuro disease are risk in this patient they are reduced.
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