Treatment of chronic inflammatory demyelinating polyneuropathy and Guillain-Barre syndrome

Abstract

Chronic inflammatory demyelinating polyneuropathy (CIDP) and Guillain-Barre syndrome (GBS) belong to the group of autoimmune demyelinating diseases of the peripheral nervous system. Different subtypes of these two conditions are known, which in some cases lead to difficulty in therapy. Although the diseases can end in complete cure, it is not uncommon for patients with disabilities and deaths.
The treatment of CIDP is divided into initial and maintenance treatment. At present, plasmapheresis (PE), corticosteroids (CS), intravenous and subcutaneous immunoglobulin have proven to be effective in the treatment of CIPD and are considered to be first-line therapy (6). Intravenous immunoglobulin (IvIg) and plasmapheresis (PE) are effective in Guillain-Barre syndrome, showing the same efficacy profile. No other treatments have been proven to affect the disease.
Various studies have found that, despite the recommendations of the American Association of Neurologists (AAN) and the European Federation of Neurological Societies / Peripheral Nerve Society (EFNS / PNS), many neurologists take an individual approach to the diagnosis and treatment of CIDP and GBS, often relying on personal experience and considering the cost of medications. In some cases this leads to misdiagnosis of both conditions, unappropriate therapy or treatment with subtherapeutic doses.