Chronic Inflammatory Demyelinating Polyradiculoneuropathy During the COVID-19 Pandemic: Telemedicine Limitations and Strategies for Improvement

Abstract

Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is a relapsing-remitting or progressive inflammatory neuropathy, which can present in a multitude of phenotypes. It can be a challenging condition to diagnose and requires thorough clinical evaluation and electrodiagnostic testing. With the outbreak of coronavirus disease in 2019 (COVID-19), large portions of the medical field converted to telemedicine to facilitate patient visits. We report a case of a 50-year-old female who was seen via video visit during the COVID-19 pandemic who was later diagnosed with CIDP and treated with intravenous immunoglobulins with improvement in clinical examination and electrodiagnostic testing. This case highlights the limitations of performing the neuromuscular examination via telemedicine.

Pathophysiology, diagnosis, and management of neuroinflammation in covid-19

“…Initially, concerns were raised that covid-19 or vaccination would worsen disease or precipitate relapse in patients with pre-existing inflammatory central nervous system and neuromuscular disease 157. Some evidence suggested that more substantial harms resulted from difficult and delayed diagnosis of general neurological disorders, anxiety of the unknown for patients, and reduced disease control resulting from fewer healthcare interactions and alterations in treatment strategies in the first year of covid-19, than resulted from relapses precipitated by infection or vaccination 157158…”