 |
Welcome
to the CIDP International organization
For a complete guide to treatment of children with CIDP , GBS and
any other autoimmune disease read the, "Flame within" Guide to
autoimmune diseases by CIDPUSA.It has been generally reported that
children respond well to IVIg. Read the research articles below.
Steroids may not help or may even worsen CIDP in children. Some
children may develop relapses. More frequently seen in males ,
starts at two months of age and usually presents as loss of
ambulation.
Muscle Nerve. 1997 Aug;20(8):1008-15. Related Articles,
Links
Chronic inflammatory demyelinating polyradiculoneuropathy in
children: I. Presentation, electrodiagnostic studies, and initial
clinical course, with comparison to adults.
Simmons Z, Wald JJ, Albers JW.
Division of Neurology, Pennsylvania State University College of
Medicine, Hershey Medical Center, Hershey 17033, USA.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is
rare in children. We reviewed features of 15 children with
idiopathic CIDP, and compared these to 69 adults with idiopathic
CIDP. Children demonstrated many similarities to adults: (1)
Antecedent events were uncommon. (2) There was a high frequency of
weakness and reflex loss, a relatively high frequency of sensory
loss, and a low frequency of pain and cranial neuropathies. (3)
Cerebrospinal fluid protein levels were usually elevated. (4) On
electrodiagnostic testing, not all nerve segments were abnormal, and
not all children satisfied electrodiagnostic criteria for CIDP.
Children differed from adults with CIDP in several ways: (1) The
onset of symptoms was usually more precipitous. (2) Gait
abnormalities were a more frequent presenting symptom. (3) Children
always presented with significant neurological dysfunction, and not
with the minor symptoms initially seen in some adults. The initial
response of children with CIDP to immunomodulating therapy was
excellent.
PMID: 9236792 [PubMed - indexed for MEDLINE]
----------------------------------
Muscle Nerve. 1997 Dec;20(12):1569-75. Related Articles,
Links
Chronic inflammatory demyelinating polyradiculoneuropathy in
children: II. Long-term follow-up, with comparison to adults.
Simmons Z, Wald JJ, Albers JW.
Division of Neurology, The Pennsylvania State University College of
Medicine, Hershey Medical Center, 17033, USA.
We previously reviewed the presentation, initial clinical course,
and electrodiagnostic features of children with chronic inflammatory
demyelinating polyradiculoneuropathy (CIDP). We now report the
long-term follow-up of 12 children with idiopathic CIDP, and compare
these to 62 adults with idiopathic CIDP. Children often had more
rapidly fluctuating courses than adults. A relapsing course was
significantly more common in children than in adults. The recovery
of children from each episode of deterioration was usually
excellent, and better, on average, than in adults. Ventilatory
support was never required for children with slowly evolving
illness; only 2 children with a precipitous onset clinically
resembling Guillain-Barre syndrome required ventilatory support.
Prednisone, plasma exchange, and intravenous immunoglobulin (IVIg)
usually were effective in children. Multiple courses of IVIg could
be given with continued efficacy. Treatment often could be
discontinued in children with relapsing courses. The prognosis for
children was excellent. Adults demonstrated a good, but more
variable, outcome.
PMID: 9390670 [PubMed - indexed for MEDLINE]
----------------------------------
Singapore Med J. 2004 Nov;45(11):536-7. Related Articles,
Links
Chronic inflammatory demyelinating polyneuropathy in a child:
clinical-spinal MR imaging correlation.
Likasitwattanakul S, Visrutaratna P.
Department of Pediatrics, Faculty of Medicine, Chiang Mai
University, Chiang Mai 50200, Thailand. slikasit@mail.med.cmu.ac.th
Spinal magnetic resonance (MR) imaging of a 3-year-old girl with
chronic inflammatory demyelinating polyneuropathy (CIDP) showed
thickened and marked enhancement of the lumbosacral nerve roots.
These abnormalities resolved after steroid treatment. MR imaging of
the cauda equina may be helpful in the diagnosis of CIDP.
Publication Types:
Case Reports
PMID: 15510327 [PubMed - indexed for MEDLINE]
----------------------------------
Pediatr Neurol. 2003 Sep;29(3):236-8. Related Articles,
Links
Progressive muscle weakness after high-dose steroids in two children
with CIDP.
Rostasy KM, Diepold K, Buckard J, Brockmann K, Wilken B, Hanefeld F.
Department of Pediatrics and Neuropediatrics,
Georg-August-Universitat Gottingen,., Gottingen, Germany.
Corticosteroids and intravenous immunoglobulins belong to the first
line of treatment in chronic inflammatory demyelinating
polyneuropathy. In patients with a progressive course, plasma
exchange and immunomodulatory drugs are added to the regimen. To
reduce the side effects of long-term oral prednisolone, high-dose
pulsatile intravenous methylprednisolone treatment has been
advocated. We report two children with chronic inflammatory
demyelinating polyneuropathy who, after high-dose intravenous
pulsatile methylprednisolone, experienced a significant clinical
deterioration with profound loss of muscle strength. Both patients
improved after changing treatment to immunoglobulins in one and
cyclosporine combined with immunoglobulins and oral prednisolone in
the other.
Publication Types:
Case Reports
PMID: 14629908 [PubMed - indexed for MEDLINE]
---------------------------------
Neuromuscul Disord. 2000 Aug;10(6):398-406. Related Articles,
Links
Childhood chronic inflammatory demyelinating polyneuropathy:
clinical course and long-term outcome.
Ryan MM, Grattan-Smith PJ, Procopis PG, Morgan G, Ouvrier RA.
Department of Neurology, The Royal Alexandra Hospital for Children,
Sydney, Australia. ryan_mo@a1.tch.harvard.edu
We reviewed the clinical history, electrophysiologic and pathologic
findings, and response to therapy of 16 children with chronic
inflammatory demyelinating polyneuropathy. The majority presented
with lower limb weakness. Sensory loss was uncommon. The illness was
monophasic in seven children, relapsing in six, and three had a
slowly progressive course. All patients were treated with
immunosuppressive agents. In 11, the initial treatment was
prednisolone. All had at least a short-term response but five went
on to develop a relapsing course. Intravenous immunoglobulin was the
initial treatment in four patients. Three responded rapidly, with
treatment being stopped after a maximum of 5 months. In resistant
chronic inflammatory demyelinating neuropathy, in addition to
prednisolone and immunoglobulin, plasma exchange, azathioprine,
cyclosporine, methotrexate, cyclophosphamide and pulse
methylprednisolone were tried at different times in different
patients. On serial neurophysiologic testing slowing of nerve
conduction persisted for long periods after clinical recovery.
Follow-up was for an average of 10 years. When last seen 14 patients
were asymptomatic, two having mild residual deficits. Childhood
chronic inflammatory demyelinating neuropathy responds to
conventional treatment and generally has a favourable long-term
outcome.
Publication Types:
Clinical Trial
PMID: 10899445 [PubMed - indexed for MEDLINE]
----------------------------------
Eur J Paediatr Neurol. 1998;2(4):169-77. Related Articles,
Links
Childhood chronic inflammatory demyelinating polyneuropathy.
Nevo Y.
The Institute for Child Development, Division of Pediatrics, Dana
Children's Hospital, Sackler School of Medicine, Tel Aviv
University, Israel.
Chronic inflammatory demyelinating polyneuropathy (CIDP) is a
chronic disorder of the peripheral nervous system with sensory and
motor involvement, and insidious onset over a period of months. In
children and adults, both proximal and distal muscles are affected.
Muscle stretch reflexes are absent or depressed. Laboratory findings
include elevated cerebrospinal fluid protein with no increase of
mononuclear cells. Electrophysiological and pathological studies
show evidence of demyelination. No control studies of the efficacy
of immunomodulating therapy in childhood CIDP are available.
However, several studies have indicated clinical improvement after
treatment with prednisolone, plasmapheresis and intravenous
immunoglobulin, but disappointing results with other
immunosuppressive agents. While some children have a monophasic
course, with complete recovery, others have a protracted course,
with either a slowly progressive or a relapsing-remitting course,
resulting in prolonged morbidity and disability.
Publication Types:
Review
PMID: 10726588 [PubMed - indexed for MEDLINE]
-------------------------------
Pediatr Neurol. 2001 Mar;24(3):177-82. Related Articles,
Links
Chronic inflammatory demyelinating polyneuropathy in childhood.
Connolly AM.
Department of Neurology, St. Louis Children's Hospital, Washington
University of Medicine, St. Louis, Missouri 63110, USA.
Chronic inflammatory demyelinating polyneuropathy (CIDP) in children
is relatively rare. However, it has been recognized for many years.
In patients presenting with this disease, subacute onset of weakness
usually develops over at least 2 months and often progresses to a
loss of ambulation. Some children's initial presentations may mimic
Guillain-Barre syndrome. Dysasthesias are common. Males are affected
more than females, and antecedent illnesses or vaccinations occur in
approximately half of patients. Physical examination reveals
diffuse, proximal greater than distal weakness, with an absence or
depression of muscle stretch reflexes. Electrophysiology confirms
demyelination, and spinal fluid examination demonstrates
albuminocytologic dissociation. The clinical presentation,
diagnosis, and prognosis of childhood CIDP are reviewed. Treatment
and immunologic features are also discussed in this article.
Publication Types:
Review
PMID: 11301217 [PubMed - indexed for MEDLINE]
|
|
|
|
|
