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Sat, 31 May 2008 17:55:07

CIDP in Children

The treatment for all the autoimmune diseases is similar. These diseases are caused by inflammation, triggered by bacteria, viruses or chemicals. To reduce inflammation. You can choose drugs or non drugs (herbal, homeopathic or natural) treatments. The cornerstone for treatment in the past has been steroids which are fast out the door due to their side effect profile. However if use steroids on alternate days and in small doses they still can provide adequate treatment. If people get a red eye it is almost always due to inflammation and quickly responds to steroid drops in a day. Autoimmune ear disease responds quickly to steroids placed in the inner ear. But intravenous steroids will help too. Turmeric is a natural steroid.

 Oral steroids cause many side effects so should only be used for a short time. Steroids will stop the inflammatory attack but then one has to uncover the reason for the attack the protein, virus, bacteria (mycoplasma)! In every autoimmune disease a foreign protein antigen is triggering the disease it need to be indentified and removed all these details you will find in the disease pages . However we check for IgG antiboidies against Herpes virus and CMV in all cases. In a remote corner of the worlduse Turmeric its a natural anti-inflammatory.

Begin treatment with diet modifications described in the diet chapter.

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 , CIDP starts at two months of age and usually presents as loss of ambulation.

Warning for children with CIDP BELOW

Do not give steroids to children they can develop permanent damage

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  CIDP, and compared these to 69 adults with  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.
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 CIDP, and compare these to 62 adults with  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.

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Chronic inflammatory demyelinating polyneuropathy