Here’s a concise comparison of Chronic Inflammatory Demyelinating Polyradiculoneuropathy (CIDP), Amyotrophic Lateral Sclerosis (ALS), Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP), and Lambert-Eaton Myasthenic Syndrome (LEMS) based on key clinical and diagnostic features:
| Feature | CIDP | ALS | AIDP | LEMS |
|---|---|---|---|---|
| Pathophysiology | Autoimmune demyelination of peripheral nerves | Degeneration of upper and lower motor neurons | Acute autoimmune demyelination of peripheral nerves | Autoimmune attack on presynaptic voltage-gated calcium channels |
| Onset | Chronic, progressive or relapsing (>2 months) | Progressive, insidious (months to years) | Acute, rapid (days to weeks) | Subacute to chronic |
| Symptoms | Symmetric weakness, sensory loss, hyporeflexia/areflexia | Muscle weakness, atrophy, fasciculations, spasticity, hyperreflexia | Symmetric weakness, sensory loss, areflexia, often post-infection | Proximal weakness, fatigability, autonomic dysfunction (e.g., dry mouth), hyporeflexia |
| Motor Involvement | Proximal and distal, lower motor neuron (LMN) | Upper motor neuron (UMN) + LMN | Proximal and distal, LMN | Proximal, improves with repeated activity (facilitation) |
| Sensory Involvement | Common (numbness, tingling) | Rare (sensory sparing) | Common (paresthesia, sensory loss) | Rare (sensory sparing) |
| Autonomic Involvement | Rare | Rare | Common (e.g., dysautonomia, heart rate variability) | Common (e.g., dry mouth, constipation) |
| Reflexes | Reduced or absent | Hyperreflexic (UMN) or mixed | Absent or reduced | Reduced, may improve with exercise |
| Electrophysiology (EMG/NCS) | Demyelinating features (slow conduction, conduction block) | Denervation, fasciculations, no sensory involvement | Demyelinating features, acute onset | Reduced CMAP amplitude, facilitation with high-frequency stimulation |
| Cerebrospinal Fluid (CSF) | Elevated protein, normal cell count (albuminocytologic dissociation) | Normal | Elevated protein, normal cell count | Normal |
| Associated Conditions | None specific, may have monoclonal gammopathy | Frontotemporal dementia (some cases) | Post-infectious (e.g., Campylobacter, CMV, EBV) | Small cell lung cancer (paraneoplastic, ~50% of cases) |
| Treatment | Immunotherapy (IVIG, corticosteroids, plasmapheresis) | Supportive, riluzole, edaravone | IVIG, plasmapheresis | 3,4-DAP, immunotherapy, treat underlying malignancy |
| Prognosis | Variable, often responds to treatment | Poor, progressive (median survival 2-5 years) | Good with treatment, most recover within months | Variable, depends on underlying malignancy and treatment response |
Key Differentiators:
- CIDP: Chronic, treatable, demyelinating neuropathy with sensory and motor involvement.
- ALS: Progressive motor neuron disease with UMN and LMN signs, no sensory loss, poor prognosis.
- AIDP: Acute form of CIDP (Guillain-Barré syndrome), often post-infectious, good recovery with treatment.
- LEMS: Neuromuscular junction disorder, often paraneoplastic, with characteristic facilitation and autonomic symptoms.
For precise diagnosis, clinical evaluation, EMG/NCS, CSF analysis, and sometimes antibody testing (e.g., anti-VGCC for LEMS) are critical.
Disclaimer: owerl is not a doctor; please consult one. Don’t share information that can identify you.
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