A 57-Year-Old Man With Unexplained Difficulty Walking

Heidi Moawad, MD

Disclosures

August 23, 2018

CIDP is treated with medications that are given during episodes, which are directed toward decreasing the inflammation. The most common medications include intravenous (IV) steroids, oral steroids, IV immunoglobulin (IVIG), and plasmapheresis.[3] Most patients respond well to steroids, IVIG, or plasmapheresis. Other treatments include immunosuppressive drugs and chemotherapeutic agents. These immunosuppressive and chemotherapeutic drugs are usually used for patients who have not responded to standard therapy, and are generally associated with more severe side effects, including hair loss, anemia, and, of course, a lowered immune function. Evidence regarding the degree of efficacy of these agents in CIDP is still emerging.

Patients with CIDP commonly experience recurrence of symptoms months or years after resolution of the symptoms. These recurrences are part of the disease process itself and not a result of unfinished treatment. Patients need to be treated when these recurrences occur. Patients with CIDP do not typically receive treatment for the condition between episodes. Besides medical treatment, physical therapy and occupational therapy are also often recommended, as symptoms of weakness do not always completely resolve.

The patient in this case was treated with IV steroids and continued to experience a decline in motor strength for 1 day, as well as urinary urgency, but did not have any respiratory muscle weakness. After 24 hours, he began to improve and noticed a substantial improvement of motor strength within days; however, he continued to have residual weakness compared with his baseline for about 6 weeks after this episode.

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