Fast Five Quiz: Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP) Presentation and Diagnosis

Jafar Kafaie, MD, PhD


June 30, 2021

CN involvement may be seen in patients with CIDP, particularly CN VII, with paralysis of both upper and lower facial muscles. Diplopia can occur with the involvement of CN III, IV, or VI. In rare cases, the bulbar muscles (eg, palate, tongue) can be affected.

Patients with CIDP do not have a normal gait; instead, an abnormal gait that corresponds to the location of weakness and the degree of proprioceptive loss can be seen. For example, patients with significant weakness in the lower extremities may walk with steppage gait (high elevation of both feet to compensate for foot dorsiflexor weakness) or a slapping gait due to deficit of proprioception in the feet. Children usually have more profound gait abnormalities than adults.

Pathologic reflexes (eg, Babinski, Chaddock, Oppenheim) are usually absent in patients with CIDP. Deep tendon reflexes are also diminished or absent, even in regions with only mild weakness.

Loss or decrease of pain and temperature sensations may occur in patients with CIDP, but it is less common than other deficits to the sensory system, such as proprioceptive and vibratory deficits and neuropathic pain in affected extremities.

Learn more about pertinent physical findings in patients with CIDP.


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