79 yr old w/symptoms of CIDP – how to be sure?

    • February 17, 2019 at 7:26 pm

      My mother has been showning significant weakening in her arms, legs in the past 60 days to where she is unable to walk. She was diagnosed with significant cervical stenosis 3 weeks ago. Met with neurologist 2 weeks ago and CIDP is being considered along with ALS. She’s sleeping more each day. Neurologist wants one more look at another EMG with an expert doing the test this Wed 2/20. He is willing to start IVIg treatment.

      Is there a definitive test that confirms this diagnosis? Is there a long process to get approval for the IVIg treatment. She’s states her head is getting heavy and breathing is changing.

      I feel like I can’t wait until Wednesday for more tests. Do we send her to the ER? She’s in an assisted living and well care for at this point but with progressive changes every 3-4 days….

    • February 18, 2019 at 1:18 pm

      Hi Lisa, CIDP can usually be distinguished through the following key tests:
      • Diminished or absent deep tendon reflexes.
      • A spinal tap, to analyze cerebrospinal fluid for elevated protein levels.
      • A Nerve Conduction Velocity Study that measures how well individual nerves can send an electrical signal from the spinal cord to the muscles.
      • Complete Blood and urine tests.
      • Nerve biopsy is a test chosen as a last resort (due to possible sensory deficit and – in some cases – chronic pain from this surgical procedure) and usually performed only when other clinical, laboratory and electrophysiological methods have failed to clarify the cause.

      CIDP and its variants can be difficult to diagnose exactly. Even assessing the results of an NCV is a bit of an art. Usually, all the tests must be made to confirm the presence of CIDP. Neurologists that have specialized in treating CIDP know this and the signs to look for. Other tests can be found in the following publication and may help you and your doctor better understand your Mom’s affliction, its variants, and how to best treat her:

    • GH
      February 18, 2019 at 11:41 pm

      The spinal fluid test mentioned by Jim is routine when GBS or CIDP are suspected. I wouldn’t say it is “definitive,” however. Sometimes the indication can be weak if the illness has not progressed enough. But a good positive is indicative of either GBS or CIDP.