Atypical variants of chronic inflammatory demyelinating polyneuropathy in the structure of inflammatory diseases of the peripheral nervous system

Abstract

Objective: to identify the clinical features of atypical forms of CIDP, improve the diagnosis of this nosology at the outpatient stage by objectifying the reference points in the clinical picture and focusing the attention of primary care specialists on this pathology. Materials and methods: the medical records of 203 patients admitted to the neurological center of the Rostov State Medical University in the period from January 1, 2014 to April 1, 2024 with a diagnosis of polyneuropathy were analyzed. The examination included a general clinical and neurological examination, an electrophysiological study (stimulated electroneuromyography on the Natus Keypoint Focos neurophysiological complex), as well as laboratory evaluation of blood and cerebrospinal fluid tests. Results: to objectify the speed of diagnosis, the “debut-diagnosis” interval was calculated. In patients with the motor form of CIDP it averaged 2.2 years, in patients with the sensory form of CIDP it was 3.9 years. In the group of patients with a typical clinical picture of CIDP, this indicator ranged from 1.5 to 4.5 years. Conclusions: CIDP is a rare acquired neuropathy of dysimmune origin, heterogeneous in course and clinical manifestations, but classified as curable. The variety of forms of the disease and its course cause difficulties in timely diagnosis and initiation of pathogenetic therapy. While early diagnosis and initiation of therapy significantly improve the prognosis for this category of patients.