Ruts et al identified factors distinguishing Guillain-Barre Syndrome (GBS) with treatment-related fluctuations (TRF) from chronic inflammatory demyelinating polyneuropathy (CIDP) with acute onset. The authors are from the Dutch GBS Study Group.
Parameters:
(1) time to first deterioration
(2) number of clinical deteriorations
(3) ability to walk independently
(4) cranial nerve dysfunction
(5) electrophysiologic features compatible with CIDP
Parameter
GBS with TRF
acute onset CIDP
first deterioration
within 8 weeks
after 8 weeks
number of deteriorations
1 or 2
3 or more
walking independently
often unable
often able
cranial nerve dysfunction
present
absent
electrophysiology
not consistent with CIDP
consistent with CIDP
A patient with features of acute onset CIDP should be considered for CIDP maintenance therapy.
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