Chronic Inflammatory Demyelinating Polyneuropathy Analysis

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Chronic Illness Paper- CIDP (Chronic Inflammatory demyelinating polyneuropathy)
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Pathophysiology of Chronic Inflammatory demyelinating polyneuropathy (CIDP)
Chronic Inflammatory demyelinating polyneuropathy (CIDP) is a chronic, progressive or recurrent monophasic symmetric sensorimotor disease, immune-mediated disorder of the peripheral nerves characterized by progressive muscle weakness with altered sensations,CIDP can appear at any age, but those in the 50-60 age group tend to develop the disease than other age groups (Kohle et al., 2021). Since the neurological disease affects the peripheral nerves and nerve roots early diagnosis is prioritized to slow down and prevent further nerve damage. The cellular and humoral immunity attack myelin on large peripheral nerve fibers and this causes demyelination that is presented as weakness, numbness, sensory ataxia, and paresthesia (Ryan & Ryan, 2018).
There are various neurological complications that may share similar characteristics with CIDP, but the neurological disorder is rare. At the same time, the pathogenesis of CIDP is not well understood, but there is more research to identify diagnosis criteria that is universally acceptable. There are widely variably reported figures on the prevalence of CIPD because of the criteria used, but the estimated incidence of 0.7 to 1.6 cases per 100,000 persons per year (Ryan & Ryan, 2018). On the other hand, the “overall prevalence is estimated at 4.8 to 8.9 cases per 100,000 persons” (Ryan & Ryan, 2018). CIDP is a rare disorder, but is still the most common chronic immune-mediated neuropathy and the analysis focuses on the symptoms, complications and management of CIDP.
Description of diagnostic indicators or clinical signs/symptoms
CIDP progresses slowly for at least 2 months and while there periods of worsening conditions and improvement, the muscles around the shoulder, hip, hands, and feet tend to weaken (NORD, n.d). The weakness is linked to nerve damage where there is an alteration of the nerve signals that causes impairment of the motor function or the loss of sensations (NORD, n.d.) In peripheral neuropathies, there is a tendency for the peripheral nerves to get larger. However, it is challenging to diagnose the disease as it shares characteristics with other disorders. Peripheral nerve damage is common to other conditions such as diabetes and this needs to e diagnosed to avoid CIDP misdiagnosis. Proximal and distal weakness and sensory deficits are also common. However, patient history, physical examination, electrophysiology, nerve biopsy, and laboratory tests are necessary for diagnosis to rule out other diseases and conditions (Ryan & Ryan, 2018).
While the progression of weakness s and slowing motor nerve conduction are considered when diagnosing CIPD, there is a need for further follow-up to determine whether there are other similar conditions such as acquired demyelinating polyneuropathy. The elevated protein content of the cerebrospinal fluid (CSF) in CIDP is common and indicates problems with the central nervous system, and this includes nerve inflammation (Fisse, et al., 2020). Thus diagnosis often considers changes in the cerebrospinal fluid (CSF) and the response to treatment to deal with high CSF levels.
Complications and/or comorbidities associated with CIDP
There are different diagnostic patterns in patients with CIDP, but nerve inflammation is common in almost all cases accompanied by high protein in CSF. When there is dysfunction of the peripheral nerves, distal nerves, and nerve root there is a risk of limb weakness, numbness, and sensory deficits. Thus, weakness tends to be in the lower extremities and can permanent nerve damage causes disability. When patients get sensory impairment there is a risk of hyporeflexia or areflexia and in extreme cases, there is pain linked to neuropathy.
Slowing in the upper and lower limbs is a concern as it may affect mobility and the ability to carry out daily activities. Decreased functional mobility decreased finger dexterity and impaired balance are common in patients with CIDP (Westblad et al., 2009) . Sometimes, there is areflexia without wasting and difficulties with fine finger control (Ryan & Ryan, 2018). Patients with diabetes are at high risk of CIDP and they also tend to experience severe fatigue (Doneddu et al., 2020).
Erickson’s Developmental staging and CIDP
Erik Erikson's Stages of Psychosocial Development theory has 8 psychosocial stages. Erickson argued that people confront conflict and resolve this successfully for them to grow mentally (Santrock, 2018). However, if they cannot overcome these conflicts, they may not develop the necessary skills to face future challenges (Santrock, 2018). The first stage is infancy at eight years, but CIDP disproportionately affects adults, which means that as people age CIDP is more likely to be disruptive.
Since the age of onset for CIDP is 50 years under Erikson’s theory this falls on the seventh developmental stage (generativity versus stagnation) in middle adulthood in the 40s and 50s. It also falls in the eighth stage (integrity versus despair), which is late adulthood from the 60s onward (Santrock, 2018). In the generativity versus stagnation phase, people begin to spend more time with their families (Santrock, 2018). A person tries to be productive to offer a better future for their loved ones, and an individual wants to feel useful. However, they also question whether what they are doing is useful. Mobility issues, muscle weakness, and pain limit the ability to carry out daily activities. Family and work are important to middle-aged adults.
Muscle weakness tends to affect mobility, while sensory impairment may affect balance in patients with CIDP. The problem associated with balance increase the risk of falling. There is a risk of vibration perception threshold (VPT) among CIDP patients that those without where it is reduced or lack of t...