CIDP Vaccine Injury Cases
What is Chronic inflammatory demyelinating polyneuropathy (CIDP)?
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a neurological disorder characterized by progressive weakness and impaired sensory function in the legs and arms. The disorder, which is sometimes called chronic relapsing polyneuropathy, is caused by damage to the myelin sheath (the fatty covering that wraps around and protects nerve fibers) of the peripheral nerves. Although it can occur at any age and in both genders, CIDP is more common in young adults, and in men more so than women. It often presents with symptoms that include tingling or numbness (beginning in the toes and fingers), weakness of the arms and legs, loss of deep tendon reflexes (areflexia), fatigue, and abnormal sensations. CIDP is closely related to Guillain-Barre syndrome and it is considered the chronic counterpart of that acute disease.
What is the prognosis?
The course of CIDP varies widely among individuals. Some may have a bout of CIDP followed by spontaneous recovery, while others may have many bouts with partial recovery in between relapses. The disease is a treatable cause of acquired neuropathy and initiation of early treatment to prevent loss of nerve axons is recommended. However, some individuals are left with some residual numbness or weakness.
What treatment is available?
Treatment for CIDP includes corticosteroids such as prednisone, which may be prescribed alone or in combination with immunosuppressant drugs. Plasmapheresis (plasma exchange) and intravenous immunoglobulin (IVIg) therapy are effective. IVIg may be used even as a first-line therapy. Physiotherapy may improve muscle strength, function and mobility, and minimize the shrinkage of muscles and tendons and distortions of the joints.
How does Guillain-Barré Syndrome (GBS) differ from CIDP?
CIDP is distinguished from Guillain-Barré Syndrome (GBS) by time course and steroid responsiveness. Unlike GBS, CIDP typically has a slower course and can often times take up to 8 weeks to achieve peak weakness. GBS, on the other hands, has a rapid onset of ascending paralysis, which can occur in a matter of days and has a peak weakness in less than four weeks after onset. Some CIDP patients may have a more acute onset and may present as multiple occurrences of GBS with ventilator failure. Typically, most patients present with weakness, both proximal and distal, paresthesias, and sensory loss that may be slowly progressive or have a more relapsing/remitting course.
Can CIDP be caused by vaccines?
CIDP is often considered the “chronic” version of GBS and is part of the same family of autoimmune diseases. The influenza vaccine has been strongly linked as a cause of GBS and since GBS and CIDP are part of the same family of disease, many cases of CIDP have been compensated in the United States Court of Federal Claims.
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