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

Overview

Journal Pain Ther

Date 2019 Jun 16

PMID 31201680

Citations 11

Authors

Athena Michaelides

Robert D M Hadden

Ptolemaios G Sarrigiannis

Marios Hadjivassiliou

Panagiotis Zis

Affiliations

Soon will be listed here.

Abstract

Introduction: Although 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.

Methods: A systematic literature search was conducted on PubMed database.

Results: Our 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.

Conclusions: Pain in CIDP is an underexplored field. Future research should focus on the natural history, phenomenology, and management of pain in CIDP.

Citing Articles

Pediatric Chronic Inflammatory Demyelinating Polyneuropathy: Challenges in Diagnosis and Therapeutic Strategies.

Alawneh I, Alenizi A, Paiz F, Nigro E, Vajsar J, Gonorazky H Paediatr Drugs. 2024; 26(6):709-717.

PMID: 39192168 DOI: 10.1007/s40272-024-00646-6.

Ultramicronized Palmitoylethanolamide in the Management of Neuropathic Pain Related to Chronic Inflammatory Demyelinating Polyneuropathy: A Proof-of-Concept Study.

Cocito D, Peci E, Torrieri M, Clerico M J Clin Med. 2024; 13(10).

PMID: 38792328 PMC: 11122609. DOI: 10.3390/jcm13102787.

Sensory Chronic Inflammatory Demyelinating Polyradiculoneuropathy: Neglected Immunotherapy-Responsive Sensory Neuropathy.

Oh S, King P J Clin Neurol. 2024; 20(3):276-284.

PMID: 38330421 PMC: 11076188. DOI: 10.3988/jcn.2023.0469.

Development of Good Manufacturing Practice-Compatible Isolation and Culture Methods for Human Olfactory Mucosa-Derived Mesenchymal Stromal Cells.

Kelly C, Lindsay S, Smith R, Keh S, Cunningham K, Thummler K Int J Mol Sci. 2024; 25(2).

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What's New in Neuropathy?.

Varrassi G, Tamburin S, Zis P, Guardamagna V, Paladini A, Rekatsina M Cureus. 2023; 15(9):e44952.

PMID: 37818524 PMC: 10561699. DOI: 10.7759/cureus.44952.

References

Ormerod I, Waddy H, Kermode A, Murray N, Thomas P . Involvement of the central nervous system in chronic inflammatory demyelinating polyneuropathy: a clinical, electrophysiological and magnetic resonance imaging study. J Neurol Neurosurg Psychiatry. 1990; 53(9):789-93. PMC: 1014259. DOI: 10.1136/jnnp.53.9.789. View

Sinnreich M, Klein C, Daube J, Engelstad J, Spinner R, Dyck P . Chronic immune sensory polyradiculopathy: a possibly treatable sensory ataxia. Neurology. 2004; 63(9):1662-9. DOI: 10.1212/01.wnl.0000142507.12763.58. View

Boukhris S, Magy L, Khalil M, Sindou P, Vallat J . Pain as the presenting symptom of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). J Neurol Sci. 2007; 254(1-2):33-8. DOI: 10.1016/j.jns.2006.12.012. View

Baumer D, Grant D, Knight R, Buckley C, Bennett D, Rinaldi S . CIDP presenting as recurrent severe back pain without weakness or sensory loss. Pract Neurol. 2016; 16(6):488-492. DOI: 10.1136/practneurol-2016-001397. View

Rotta F, Sussman A, Bradley W, Ayyar D, Sharma K, Shebert R . The spectrum of chronic inflammatory demyelinating polyneuropathy. J Neurol Sci. 2000; 173(2):129-39. DOI: 10.1016/s0022-510x(99)00317-2. View

Shah S, Chandrashekar H, Manji H, Davagnanam I . Cranial nerve, spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy. Pract Neurol. 2012; 12(1):68-9. DOI: 10.1136/practneurol-2011-000040. View

Caporale C, Staedler C, Gobbi C, Bassetti C, Uncini A . Chronic inflammatory lumbosacral polyradiculopathy: a regional variant of CIDP. Muscle Nerve. 2011; 44(5):833-7. DOI: 10.1002/mus.22165. View

Ginsberg L, Platts A, Thomas P . Chronic inflammatory demyelinating polyneuropathy mimicking a lumbar spinal stenosis syndrome. J Neurol Neurosurg Psychiatry. 1995; 59(2):189-91. PMC: 486000. DOI: 10.1136/jnnp.59.2.189. View

Misra V, Walker R . Acute-onset painful upper limb multifocal demyelinating motor neuropathy. J Neurol. 2001; 247(12):949-54. DOI: 10.1007/s004150070052. View

10.

Leitch M, Sherman W, Brannagan 3rd T . Distal acquired demyelinating symmetric polyneuropathy progressing to classic chronic inflammatory demyelinating polyneuropathy and response to fludarabine and cyclophosphamide. Muscle Nerve. 2012; 47(2):292-6. DOI: 10.1002/mus.23629. View

11.

Simmons Z, Wald J, Albers J . Chronic inflammatory demyelinating polyradiculoneuropathy in children: I. Presentation, electrodiagnostic studies, and initial clinical course, with comparison to adults. Muscle Nerve. 1997; 20(8):1008-15. DOI: 10.1002/(sici)1097-4598(199708)20:8<1008::aid-mus11>3.0.co;2-r. View

12.

Gorson , Chaudhry V . Chronic Inflammatory Demyelinating Polyneuropathy. Curr Treat Options Neurol. 2000; 1(3):251-262. DOI: 10.1007/s11940-999-0007-7. View

13.

Rajabally Y, Chavada G . Lewis-sumner syndrome of pure upper-limb onset: diagnostic, prognostic, and therapeutic features. Muscle Nerve. 2009; 39(2):206-20. DOI: 10.1002/mus.21199. View

14.

Pytel P, Rezania K, Soliven B, Frank J, Wollmann R . Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with hypertrophic spinal radiculopathy mimicking neurofibromatosis. Acta Neuropathol. 2003; 105(2):185-8. DOI: 10.1007/s00401-002-0616-7. View

15.

Kacar A, Bjelica B, Bozovic I, Peric S, Nikolic A, Cobeljic M . Neuromuscular disease-specific questionnaire to assess quality of life in patients with chronic inflammatory demyelinating polyradiculoneuropathy. J Peripher Nerv Syst. 2018; 23(1):11-16. DOI: 10.1111/jns.12251. View

16.

Liewluck T, Engelstad J, Mauermann M . Immunotherapy-responsive allodynia due to distal acquired demyelinating symmetric (DADS) neuropathy. Muscle Nerve. 2016; 54(5):973-977. DOI: 10.1002/mus.25206. View

17.

Zis P, Sarrigiannis P, Rao D, Hadjivassiliou M . Gluten neuropathy: prevalence of neuropathic pain and the role of gluten-free diet. J Neurol. 2018; 265(10):2231-2236. DOI: 10.1007/s00415-018-8978-5. View

18.

Gorson K, Ropper A, Weinberg D . Upper limb predominant, multifocal chronic inflammatory demyelinating polyneuropathy. Muscle Nerve. 1999; 22(6):758-65. DOI: 10.1002/(sici)1097-4598(199906)22:6<758::aid-mus13>3.0.co;2-n. View

19.

Morrison K, Davies P . Chronic inflammatory demyelinating polyneuropathy presenting with headache and papilledema. Headache. 2004; 39(4):299-300. DOI: 10.1046/j.1526-4610.1999.3904299.x. View

20.

Lewis R, Sumner A, Brown M, Asbury A . Multifocal demyelinating neuropathy with persistent conduction block. Neurology. 1982; 32(9):958-64. DOI: 10.1212/wnl.32.9.958. View