Immunotherapy-responsive allodynia due to distal acquired demyelinating symmetric (DADS) neuropathy

Liewluck, Teerin; Engelstad, JaNean; Mauermann, Michelle L.

doi:10.1002/mus.25206

Cited by 4 publications

(8 citation statements)

References 17 publications

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“…None of the papers included in this review reported on a patient where pain was an isolated symptom. Pain always coexisted with other CIDP features, the most prominent being weakness (reported by 85% of painful CIDP patients) [17–20, 23, 24, 26–31, 33–35, 37, 38, 40–42, 45–50, 52] followed by numbness (reported by 75% of painful CIDP patients) [17, 19, 21–39, 41–50, 52].…”

Section: Resultsmentioning

confidence: 99%

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Pain in Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Systematic Review and Meta-Analysis

et al. 2019

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IntroductionAlthough chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) predominantly affects large myelinated fibers, many patients have pain. The aim of this paper is to systematically review the current literature regarding CIDP with a particular focus on epidemiological and clinical characteristics of painful CIDP.MethodsA systematic literature search was conducted on PubMed database.ResultsOur search strategy identified 146 articles. Thirty-eight papers, reporting on 991 patients, met the inclusion criteria and were used for this review. The pooled estimate of the prevalence of pain at any point within the course of CIDP was 46% (95% CI 36–57%). Immune treatment of CIDP might be adequate as monotherapy for the management of pain. Treatment specific to pain currently shows effectiveness as adjuvant treatment when CIDP is treated and pain persists.ConclusionsPain in CIDP is an underexplored field. Future research should focus on the natural history, phenomenology, and management of pain in CIDP.

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Section: Resultsmentioning

confidence: 99%

“…No robust data regarding the effect of treatment for pain in CIDP were available. The effectiveness of CIDP treatment in pain was clearly reported only in 46 patients [17–19, 23–26, 28, 30–35, 37, 41–45, 47–49]. Of those, in 41 patients (89%), treatment for CIDP had reduced pain.…”

Section: Resultsmentioning

confidence: 99%

Pain in Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Systematic Review and Meta-Analysis

et al. 2019

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“…Edema and acute inflammation might cause reversible enlargement, which reacts to immune treatment, while Schwann cell proliferation and fibrosis might cause permanent enlargement. Even in the same patient, the patchy nature of pathologic changes in CIDP may make CSA enlargement heterogeneous.…”

Section: Discussionmentioning

confidence: 99%

Serial nerve ultrasound and motor nerve conduction studies in chronic inflammatory demyelinating polyradiculoneuropathy

Niu

Liu

et al. 2019

Muscle and Nerve

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Introduction The objective of this study was to evaluate the correlation between cross‐sectional area (CSA) and nerve conduction studies (NCS) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and to determine how CSA changes over time after standard treatment. Methods Fifty‐four patients with CIDP were recruited prospectively, and 21 patients were followed for more than 6 months. Ultrasonography and motor NCS were performed in the median and ulnar nerves. Results No or weak correlation was observed between the maximum CSA and motor conduction velocity. There were segmental nerve enlargements at 61% of sites with conduction block or temporal dispersion. Among 19 patients with clinical improvement after immunotherapy, CSA decreased to normal in 5, increased in 10, and were unchanged in 4. Discussion Different patterns of CSA and motor NCS changes after immune treatment may indicate different CIDP pathologic mechanisms. Exploration of these pathologic mechanisms could guide treatment choices in the future. Muscle Nerve, 2019

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“…Goebel et al investigated the intensity and distribution of pain in 24 patients with CIDP and concluded that “the notion of CIDP as a painless disorder should be revisited” . There are also several case reports about pain in CIDP patients . However, well‐designed studies about NeP in CIDP are limited, and most of them are conducted on small cohorts of patients …”

Section: Introductionmentioning

confidence: 99%

“…7 There are also several case reports about pain in CIDP patients. [8][9][10] However, well-designed studies about NeP in CIDP are limited, and most of them are conducted on small cohorts of patients. 6,7,11,12 The aims of this study were: (a) to gather information about frequency, severity, and features of NeP in a large cohort of CIDP The variants of the disease and electrophysiological findings were established using the same criteria.…”

Section: Introductionmentioning

confidence: 99%

One‐year follow‐up study of neuropathic pain in chronic inflammatory demyelinating polyradiculoneuropathy

Bjelica

Perić

Božović

et al. 2019

J Peripheral Nervous Sys

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We sought to gather information about frequency and features of neuropathic pain (NeP) in chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) patients and to investigate course of NeP during 1‐year follow‐up. Study included 105 patients diagnosed with CIDP. Patients with diabetes (N = 26) were excluded. NeP was diagnosed by the official guidelines and painDETECT questionnaire (PD‐Q). Medical Research Council Sum Score (MRC‐SS), INCAT disability and sensory scores, and Beck Depression Inventory were also measured. PD‐Q showed presence of NeP in 16 (20%) of 79 CIDP patients and their mean pain was moderate (5.1 ± 3.0 of 10). Diagnostic delay in CIDP patients with NeP was prolonged compared to CIDP patients without NeP (21 ± 28 vs 9 ± 12 months, P < .05). Slowly progressive course of the disease was more frequent in patients with NeP (81% vs 52%, P < .05). Patients with NeP had worse INCAT sensory score (P < .01), INCAT disability score (P < .05), MRC‐SS, as well as worse disease outcome at time of testing (P < .05). Depression was more common in patients with NeP (69% vs 17%, P < .01). During 1‐year follow‐up, majority of our CIDP patients had good control of NeP with gabapentinoids or amitriptyline. NeP was common in our cohort of non‐diabetic CIDP patients. It was associated with worse functional disability, worse sensory deficit, and depression. Special attention should be paid to CIDP patients with NeP because they request additional symptomatic therapy that appeared efficacious in our cohort.

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Immunotherapy-responsive allodynia due to distal acquired demyelinating symmetric (DADS) neuropathy

Abstract: DADS neuropathy can present with pain and a normal neurological examination apart from allodynia. Nerve conduction studies are necessary for diagnosis. These patients respond to immunotherapy better than typical DADS neuropathy patients with sensory ataxia. Muscle Nerve 54: 973-977, 2016.

Cited by 4 publications

References 17 publications

Pain in Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Systematic Review and Meta-Analysis

Pain in Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Systematic Review and Meta-Analysis

Serial nerve ultrasound and motor nerve conduction studies in chronic inflammatory demyelinating polyradiculoneuropathy

One‐year follow‐up study of neuropathic pain in chronic inflammatory demyelinating polyradiculoneuropathy

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