Chronic Inflammatory Demyelinating Polyradiculoneuropathy Follow-up

Updated: Oct 02, 2017
  • Author: Richard A Lewis, MD; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Follow-up

Further Outpatient Care

Outpatient care consists of visits to specialists such as neurologists and physiatrists and of treatment visits for IVIg infusions or to the plasma exchange unit.

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Further Inpatient Care

Most care is delivered on an outpatient basis, although patients may have to be admitted for a short stay for the initiation of plasma exchange or IVIg treatment, because of complications of chronic inflammatory demyelinating polyradiculoneuropathy or treatment, or for inpatient physical therapy.

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Inpatient & Outpatient Medications

Most medications are administered on an outpatient basis. IVIg can be administered as a home infusion or during an outpatient visit. An exception is plasma exchange, which requires visits to a specialized pheresis center.

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Complications

See the list below:

  • If the disease becomes severe, swallowing and breathing functions can be affected. Aspiration pneumonia, atelectasis, and respiratory failure can occur.
  • If autonomic function is involved, GI motility and bladder function can be abnormal. Orthostatic hypotension and cardiac conduction defects can occur.
  • As already discussed, complications of treatment also must be considered.
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Prognosis

Some have suggested that patients with the relapsing disease have a better prognosis than patients with the chronic progressive course. Approximately 70% of patients are said to make relatively good recovery from their relapses, and close to 90% of patients respond to initial immunosuppressive therapy. Some patients do not respond to the usual treatments and accumulate significant disability. Some patients have only a short treatment effect and become treatment dependent. A useful way of understanding the clinical status of patients is to use the CIDP activity status (CDAS). This approach has been useful for both clinical research and for clinical practice. [5]

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Patient Education

Refer to physical and occupational therapists and to a physiatrist for optimal outpatient therapy, orthotic devices, and adaptation at home.

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