Diferencia entre revisiones de «Chronic inflammatory demyelinating polyneuropathy»
| Línea 5: | Línea 5: | ||
==Clinical Features== | ==Clinical Features== | ||
*Symmetrical proximal and distal muscle weakness that is progressive for | *Symmetrical proximal and distal muscle weakness that is progressive for GREATER than two months | ||
*Impaired sensation | *Impaired sensation | ||
*Areflexia | *Areflexia | ||
Revisión del 17:43 12 sep 2020
Background
- Prevalence of 1 to 2 per 100,000 adults
- Acute variant is Guillain-Barre syndrome
- GBS is self limited whereas CIPD is progressive for more than two months
Clinical Features
- Symmetrical proximal and distal muscle weakness that is progressive for GREATER than two months
- Impaired sensation
- Areflexia
- Elevated CSF protein
- EMG studies consistent with demyelination
- Nerve demyelination on nerve biopsies
- Can be relapsing or chronic and progressive
Differential Diagnosis
Weakness
- Neuromuscular weakness
- Upper motor neuron:
- CVA
- Hemorrhagic stroke
- Multiple sclerosis
- Amyotrophic Lateral Sclerosis (ALS) (upper and lower motor neuron)
- Lower motor neuron:
- Spinal and bulbar muscular atrophy (Kennedy's syndrome)
- Spinal cord disease:
- Infection (Epidural abscess)
- Infarction/ischemia
- Trauma (Spinal Cord Syndromes)
- Inflammation (Transverse Myelitis)
- Degenerative (Spinal muscular atrophy)
- Tumor
- Peripheral nerve disease:
- Neuromuscular junction disease:
- Muscle disease:
- Rhabdomyolysis
- Dermatomyositis
- Polymyositis
- Alcoholic myopathy
- Upper motor neuron:
- Non-neuromuscular weakness
- Can't miss diagnoses:
- ACS
- Arrhythmia/Syncope
- Severe infection/Sepsis
- Hypoglycemia
- Periodic paralysis (electrolyte disturbance, K, Mg, Ca)
- Respiratory failure
- Emergent Diagnoses:
- Symptomatic Anemia
- Severe dehydration
- Hypothyroidism
- Polypharmacy
- Malignancy
- Aortic disease - occlusion, stenosis, dissection
- Other causes of weakness and paralysis
- Acute intermittent porphyria (ascending weakness)
- Can't miss diagnoses: