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Academia Mexicana de Neurología, A.C.

2017, Number 6

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Rev Mex Neuroci 2017; 18 (6)

Recommendations on the diagnosis and treatment of chronic inflammatory demyelinating polyneuropathy

Vargas-Cañas, Edwin Steven; Chiquete, Erwin; Ruano-Calderón, Luis A; León-Manríquez, Elizabeth; Salmerón-Mercado, Mónica Edith; Plascencia-Álvarez NI, Madrigal-Salas G, Zúñiga-García DG, Juárez-Jiménez H, Carrera-Pineda R

Language: Spanish
References: 55
Page: 2-19
PDF size: 414.94 Kb.


ABSTRACT

Introduction. Chronic inflammatory demyelinating polyneuropathy (or polyradiculoneuropathy, CIDP) is an uncommon entity of very heterogeneous clinical behavior, but susceptible to treatment. Several proposals on electrophysiological diagnostic criteria exist as well as numerous studies on the response to immunomodulatory treatments. The general consensus about its diagnosis and management, however, has not been reached in Mexico through its major health institutions.
Objective. To develop a guideline on definition, diagnosis and treatment of the CIDP by using the best existing scientific evidence and when not available, the consensus of experts.
Methods. A group of neurologists of Mexican institutions pertaining to the Study Group of Neuromuscular Diseases of the Mexican Academy of Neurology carried out a MEDLINE and Cochrane systematic reviews search, selecting the best available evidence and qualifying the recommendations according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) system. The recommendations are organized into short statements that are supported by a brief dissertation on the scientific evidence of which the statements derived.
Recommendations. This panel recommends testing and diagnostic criteria proposed by the EFNS/PNS (European Federation of Neurological Societies / Peripheral Nerve Society) that are described in the present document. For treatment aspects, this panel recommends intravenous immunoglobulin or steroids as first line treatment for the classical sensorimotor forms of CIDP, immunoglobulin exclusively for pure motor forms and plasma exchange in case of treatment failure or incomplete response to immunoglobulin or steroids. In case of inappropriate response or required high doses or long periods of first-line drugs, immunomodulatory adjuvant therapy should be considered alone or in combination.


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