Medicus, Vol. 28 No. 1 Neurologija, 2019.
Review article
Chronic Autoimmune Neuropathies
Ervina Bilić
Abstract
Distinguishing the difference between acute and chronic forms, including the dominant motor forms of chronic neuropathies, is essential to any clinical work related to chronic autoimmune neuropathies. Corticosteroids are not effective in the acute form of neuroimmunopathy and may lead to aggravation of multifocal motor neuropathy, as well as other dominant motor forms of chronic neuroimmunopathy. Only 51% of patients suffering from a chronic inflammatory demyelinating polyneuropathy (CIDP) have the so-called “classic form of disease”. Chronic neuroimmunopathy is a disease that persists for a long time, usually lasting more than three months, and has an oscillating, slowly progressive or relapsing-remitting course. CIDP is acquired, autoimmune, most commonly both demyelinating and sensomotoric neuropathy. In terms of clinical and electromyoneurographic (EMNG) features, the common denominator that CIDP shares with other forms of polyneuropathies, such as diabetic sensomotoric polyneuropathy, is the fact that the expected classical form of disease is seen in only one out of two patients, that the disease is nine times more common in diabetics and that CIDP can also be found as secondary neuropathy in patients with inherited demyelinating polyneuropathies. Diagnosis of CIDP requires electroneurography and diagnostic work-up that are extensive enough to exclude or demonstrate other conditions and diseases which may occur alongside this polyneuropathy. Today’s methods of immunomodulatory and immunosuppressive therapy can ensure successful treatment for a significant number of patients. This neuromuscular disease allows for a rapid recovery of severe motor deficits, as well as the monitoring of the patient’s overall recovery to the mutual satisfaction. However, motor deficiency is neither the only nor the most important clinical manifestation of this disease. Although we are more aware of the fact that significant autonomic dysfunction can occur in acute neuroimmunopathy, it can also occur in CIDP, representing an important determinant of patients’ prognosis and success of treatment.
Keywords
autoimmune neuropathy; chronic inflammatory demyelinating polyneuropathy; CIDP
Hrčak ID:
216819
URI
Publication date:
6.2.2019.
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