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November 1991

Chronic Inflammatory Demyelinating Polyneuropathy: Immunoglobulins or Plasmapheresis?

Arch Neurol. 1991;48(11):1118-1119. doi:10.1001/archneur.1991.00530230026013

To the Editor.  —Chronic inflammatory demyelinating polyneuropathy is a disease of the peripheral neuron with unknown cause. Management of the disorder is still a subject of study. Recently, several studies1-5 have demonstrated that treatment with high-dose intravenous immunoglobulin has a clear effect on chronic inflammatory demyelinating polyneuropathy. Repeated treatments for a long period are common.5 In some cases, it might be better to use plasma exchange.6 We present a patient with chronic inflammatory demyelinating polyneuropathy who was treated with high-dose intravenous immunoglobulin several times, resulting in short-term amelioration with rapid new deterioration with an initially unknown cause; plasma exchange caused rapid improvement without new deterioration.

Report of a Case.  —A 66-year-old man was admitted with paresthesia of the lower limbs that had appeared rather suddenly. Later on, progressive weakness of the legs developed, which gradually extended to the arms over a period of several weeks. There were