Review of Acute Inflammatory Demyelinating Polyradiculoneuropathy

Abstract

On average, 97% of patients in North America and Europe diagnosed with Guillain-Barré syndrome have a specific subtype known as acute inflammatory demyelinating polyradiculoneuropathy (AIDP). AIDP is suspected to be a result of proinflammatory cytokines causing demyelination, specifically within the peripheral nervous system, in response to stress. Events that precede the onset of AIDP include gastrointestinal or respiratory infections, surgeries, and trauma. AIDP primarily presents with acute ascending paralysis and areflexia. Diagnosis of AIDP is confirmed by nerve conduction studies (NCSs) with electromyography (EMG) and lumbar puncture for cerebral spinal fluid (CSF) analysis. NCS/EMG is used to assess the peripheral nerve function, and serial examinations are often needed. CSF analysis is looking to identify albumino-cytological dissociation. Most commonly, intravenous immunoglobulin is used to treat AIDP with plasmapheresis being the second most common treatment. Prognosis is dependent on the remyelination process but overall is relatively good. More than 80% of patients can walk independently within one year of recovery.