Reply To: CIDP EMG/NCV shows no demylenation

Fred,

To quote Anne Elk (Monty Python fans unite): I have a theory. Actually, it is a hypothesis, because I have not tested it with experiments. The hypothesis, though, is based on an observation. When I first came down with CIDP, I responded well and immediately to Solumedrol. While not asymptomatic, I was vastly improved by the next day. Clearly, that improvement could not have been the result of remyelination. I heard an explanation later that the Solumedrol, by reducing the inflammation, reduced the edema that was affecting the nerves and thereby resulted in a rapid response.

My hypothesis is that CIDP has two components, an inflammatory component and a demyelinating component. In most of us, the two are tightly linked. In others of us, though, they are not be so tightly linked. Perhaps, Fred, the reason IVIg/solumedrol works so well is that inflammation is your predominant nerve-damaging mechanism, but it does not result in much demyelination.

Part of the reason my neurologist does not like to do NCV tests (other than the obvious) is they are not always perceptive low levels of demyelination. He feels that paying attention to clinical symptoms is a better overall indicator.

~MarkEns