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June 2004

Forme Fruste Manifestations of Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Arch Neurol. 2004;61(6):984. doi:10.1001/archneur.61.6.984-a

I read the article by Alaedini et al1 with interest. This article reminds the reader of the difficulties in diagnosing chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), especially in those with an atypical or forme fruste manifestation.

The questions of how to document primary demyelination and how extensive these changes should be for it to be considered CIDP have not been resolved. In these 12 patients, it seems that 9 had significantly prolonged or absent F waves, and 3 had conduction block. Thus, 11 of the 12 patients had some features that suggested primary demyelination. American Academy of Neurology ad hoc committee criteria or other criteria can be used to diagnose only about 60% of patients with CIDP.