Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) is an autoimmune disorder, at times preceded by an infection, in which the myelin sheath covering nerve fibers is damaged. CIDP occurs when the immune system confuses myelin with a foreign invader and attacks it. This myelin allows electrical impulses to be effectively transmitted to muscles and helps return sensory information back to the brain. As such, when this coating is damaged, there can be impaired sensory function and loss of motor coordination. CIDP is closely related to Guillain-Barre Syndrome (GBS) and Acute Disseminated Encephalomyelitis (ADEM) and is often referred to as their chronic counterpart. GBS and ADEM typically entail a rapid onset and subsequent remission whereas CIDP can be lasting with recurring and worsening symptoms. Vaccines have been implicated in both a) the development of CIDP in patients with no history of the disease, and b) relapse in patients with a prior history of CIDP.
What are the Symptoms of CIDP?The onset of CIDP has been described as innocuous with a slow progression that can occur over the course of several relapses. Periodic cycles of remission and relapse may occur in months-long intervals. If symptoms persist for 8 weeks or more, a diagnosis can be made. Preceding infection has been reported in some cases. Limb weakness is characteristic, specifically proximal weakness, in which muscles closest to the torso are affected first. CIDP is known to impair sensory-motor function, so symptoms such as tingling and numbness in the extremities and frequent "foot fall" have been associated. There may also be a loss of deep tendon reflexes, fatigue, and other abnormal sensations. CIDP affects slightly more men than women and is reported more frequently in young adults.
How is CIDP Diagnosed?A diagnosis may be missed until symptoms become severe, due to a characteristically gradual onset. Because of CIDP's many variants, it is often confused for other forms of neuropathy and vice-versa. It is essential that one equips their physician with a thorough medical history and records. An EMG or nerve conduction study could be ordered by a neurologist. Cerebral spinal fluid may be tested for high levels of protein. Finally, a nerve biopsy might be conducted.
How is CIDP Treated?As with ADEM, corticosteroids such as prednisone may be administered to help the afflicted regain lost strength. Plasma exchange and intravenous immunoglobulin therapy may also be prescribed. Progressive disability could further necessitate physical therapy and orthotic devices and treatment could thus become long-term.
What is the Prognosis?Response to treatment varies, however CIDP is generally treatable. Recovery could be spontaneous and in full or could entail multiple bouts of symptoms followed by partial relief. Early treatment is recommended to reduce the risk of lost nerve axons which could cause permanent residual symptoms. It is not uncommon to experience a permanent partial loss in feeling in the extremities and muscle weakness in affected muscles may also become lasting.
CIDP and VaccinationA nationwide immunization protocol was ordered in 1976 in response to instances of swine flu detected within a military base. Reports of Guillain-Barre Syndrome cases increased during that time period and, although cases of GBS linked to the flu shot have since returned to a normal rate, it is still a matter of concern. Because it is now the most widely administered vaccine, GBS, ADEM and CIDP are most commonly linked back to the flu shot. The Vaccine Injury Compensation Program (VICP) has also acknowledged and compensated claims of CIDP as a result of the DTaP, Hepatitis B, and MMR vaccines, among others.
It is also of import to note that, while CIDP is predominant in younger individuals, the flu shot itself is most heavily recommended to the elderly, and as such there are many cases of CIDP linked to vaccination in the geriatric population. One case study outlined the diagnosis and treatment of a 74-year-old male, with no previous neurological history, who began showing signs of CIDP two days after an influenza vaccination. Another study followed a 78-year-old male, wherein doctors discovered an incidence of GBS in childhood. A relapse was triggered by his recent influenza vaccination and then developed into CIDP.
Compensation for CIDP Caused by a VaccineIf you believe that you or a loved one have incurred CIDP as a result of a vaccination, time is of the essence. There is a strict three (3) year statute of limitations for you to file a claim for compensation in vaccine court. We recommend you call an experienced vaccine injury attorney as soon as possible to secure your claim. One must also obtain any medical records relating to the vaccine, including proof of immunization and any follow-ups or hospital visits, as these will be necessary to prove your claim. Because vaccine injury claims are handled on the federal level, you may never have to appear in court, and all lawyer's fees are reimbursed by the government if the claim is valid.
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