Acute Inflammatory Demyelinating Polyradiculoneuropathy Follow-up

Updated: Jul 26, 2021
  • Author: Emad R Noor, MBChB; Chief Editor: Nicholas Lorenzo, MD, CPE, MHCM, FAAPL  more...
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Follow-up

Further Outpatient Care

Generally, all patients in whom AIDP is suspected should be admitted for further monitoring and treatment.

Patients who present with mild neurologic impairment after already reaching a plateau can be treated as outpatients with close supervision.

Upon discharge, patients require several follow-up visits to ensure that relapses do not occur and to help coordinate home-health services if necessary. Physical and occupational therapy, either in a long-term rehabilitation unit or at home, help many patients return more rapidly to their baseline level of activity.

Relapses occur (10%–20%) following completion of plasma exchange, and these relapses frequently respond to a second course of treatment. Similarly, relapses that follow IVIG therapy also respond to a second course.

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Further Inpatient Care

Based on the severity of symptoms, patients with acute inflammatory demyelinating polyradiculoneuropathy (AIDP) may require further inpatient services.

  • Patients should have cardiac monitoring to confirm and treat arrhythmias.

  • Pulmonary function tests such as FVC and negative inspiratory pressure should be performed 3–4 times a day until a patient has reached a plateau for several days.

  • Transfer to an ICU is recommended for patients with worsening respiratory effort (ie, FVC < 20 mL/kg) or cardiac arrhythmias.

  • Physical therapy should be initiated early to help increase patient activity and mobility. Patients who do not recover quickly benefit by transfer to an inpatient rehabilitation center before returning home.

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Transfer

Transfer patients to the ICU when respiratory failure is impending or when cardiac arrhythmias are occurring.

Transfer patients to regional or tertiary hospitals if a community hospital does not have an ICU or is unable to provide IVIg or plasmapheresis therapy.

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