Inflammatory

I think we tend to forget how important the inflammatory part of our disease really is. When I was first diagnosed, Solumedrol gave me back a great deal of my function, in less than 24 hours. It is highly unlikely that Solumedrol had any significant immunosuppressant effect so quickly, so I have to think that there was a substantial reduction in inflammation.

The “P” in CIDP is usually an abbreviation for “polyneuropathy.” However, it is also, and probably more precisely, an abbreviation for poly(radiculo)neuropathy. Poly(radiculo)neuropathy not only include the peripheral nerves, but also the nerve roots at the spine. My guess is that if the nerve roots are significantly inflamed, there is a large reduction in function, no matter how good the nerves further out are; rather like a kinked hose near the faucet. A good anti-inflammatory, such as a steroid or IVIg, would make a big difference, by unkinking the hose.

As a guess, the balance between inflammation and demyelination, which of course are inter-related, might help explain some of the variation in the disease course.

MarkEns