DESCRIPTION
CIDP causes damage to the nerve roots and nerves that control movement and, sometimes, sensation. Nerves are like wires that send signals to your muscles so they can move. They have an inner part, called the axon, and a coating, called the myelin sheath. The myelin sheath insulates the nerves and helps the signal travel more efficiently. CIDP typically damages the myelin sheath. This is known as demyelination. In some cases, CIDP can mostly damage the axon instead. The axon connects neurons together.
A typical case of CIDP causes weakness on both sides of the body that gets progressively worse over at least 8 weeks. This is known as symmetric weakness. CIDP can also cause changes in sensation or feeling, resulting in tingling or numbness. There are some less common variants of CIDP. These other variants may have slightly different sets of symptoms:
- Multifocal acquired demyelinating sensory and motor neuropathy (MADSAM)
- Sensory-predominant CIDP
- Distal acquired demyelinating symmetric (DADS) neuropathy
- Pure motor CIDP
- Neurofascin antibody-mediated CIDP
CIDP symptoms can vary significantly from very mild to severe. Milder cases of CIDP may cause mild weakness. In these cases, children may trip more often or have trouble with buttons or zippers. More severe cases may make it difficult to do daily tasks of living, like walking or eating.
CIDP does not usually cause death or shorten the life span.
SIGNS AND SYMPTOMS
Symptoms of CIDP are usually progressive. This means that they will continue to worsen for at least 8 weeks.
The usual symptoms of CIDP include:
- Muscle weakness. Muscle weakness in CIDP worsens slowly and occurs on both sides of the body. It usually includes both:
- Proximal muscles. These are muscles closer to the torso, such as hip or shoulder muscles.
- Distal muscles. These are muscles further from the torso, such as finger or ankle muscles.
- Sensory changes. These might include:
- Sensations of tingling. May feel like pins and needles.
- A loss of feeling is also reported.
- Movement issues. An unsteady gait or frequent tripping can cause falls.
CIDP can also sometimes cause a mild tremor in children.
CIDP usually begins very gradually over 8 weeks or more. However, in some cases, symptoms come on more quickly. Weakness and sensory changes may become more severe as the disease progresses, but they should improve once treatment is started.
OUTLOOK
When treated, most children with CIDP will significantly improve. About 30% will be cured or go into remission. Remission means having no symptoms for at least 5 years.
Upon first being treated, most children will have improvement, but 10% to 15% will not respond. About half of children will not have any new symptoms after treatment is finished. This is known as a monophasic course. The other half will still have symptoms that come and go and may require ongoing treatment. This is known as a relapsing and remitting course.
Impact on Daily Life
Over 80% of children with CIDP will be fully independent as adults. If CIDP symptoms are mild, they may not impair daily activities at all.
However, if more severe, some things may become more difficult. Since CIDP causes weakness, it may be harder to:
- Participate in certain sports or activities, like riding a bike or participating in physical education
- Use buttons or zippers
- Hold a fork
- Walk
Sensory changes may also make balance more difficult.
CIDP doesn’t seem to affect the way children grow or learn, or their general intelligence.
In addition to affecting physical activity, children may have some disruption to their usual schedules. They may need to:
- Receive IV medications at an infusion center or hospital or at home
- Work with physical or occupational therapists to help regain strength
- Attend more doctor’s visits
Impact on Education
Depending on degree of disability:
- Physical education may need to be modified
- Children may need more time getting from class to class
- Stairs may be difficult
Diet and Exercise in CIDP
It is important for children with CIDP to continue with physical activity, exercise, and stretching. This can help to strengthen some of the weak muscles. Stretching also prevents the formation of contractures. Contractures can form when a joint gets stuck in an abnormal position due to weakness.
A healthy diet is always helpful. However, there are no specific changes to the diet that need to be made for children with CIDP. Children on steroids may have increased appetite and weight gain. Working with a pediatrician or dietitian to ensure healthy eating habits can be especially helpful in these cases.
