Defining chronic inflammatory demyelinating polyradiculoneuropathy subtypes

Chronic inflammatory neuropathies include multifocal motor neuropathy, which is purely motor and often associated with complement-fixing antibodies to ganglioside GM1, paraproteinaemic demyelinating neuropathy associated with IgM paraprotein and antibodies to myelin-associated glycoprotein, and a heterogeneous group of conditions collected under the umbrella term chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Understanding the cause and improving the treatment of CIDP requires refining its subtypes into homogeneous entities.1 The paper by Ikeda et al is a further step in this direction.2 They classified 106 patients with CIDP, all of whom had sural nerve biopsies, into subtypes and reported their electrophysiological and pathological characteristics. In typical CIDP, nerve conduction was especially slowed in proximal and distal nerve segments, while in multifocal acquired demyelinating sensory and motor neuropathy (MADSAM) these portions were spared. The relatively minor average …