Chronic inflammatory demyelinating polyneuropathy (CIDP) usually is diagnosed in patients who have a generalized disorder. However, there are focal syndromes that have been observed and diagnosed under different names that meet many of the clinical and electrodiagnostic criteria of CIDP and may be referred to as “focal” CIDP.
Charcot-Marie-Tooth disease may be confused with chronic inflammatory demyelinating polyneuropathy, resulting in inappropriate and hazardous treatments. Age at onset < 40 years, a family history of neuropathy, absence of nerve hypertrophy on magnetic resonance imaging, and poor response to intravenous immune globulin treatment should prompt a genetic evaluation.
Acute inflammatory demyelinating polyneuropathy and acute-onset chronic inflammatory demyelinating polyneuropathy (CIDP) may present with identical clinical pictures and can be differentiated only with the passage of time. CIDP will have a slower course of progression and may involve relapses.
Anti-MAG antibody-associated neuropathy may present as many disorders, including small fiber neuropathy, sensorimotor neuropathy, Guillain-Barré-like syndrome, and multifocal motor neuropathy. Rituximab appears to be the best therapeutic option.
Other than the identification of a specific vitamin or essential element deficiency, overall nutritional status does not appear to play any role in the development of idiopathic neuropathies in adults.