How to treat chronic inflammatory demyelination

Chronic inflammatory demyelination is a complication caused by chronic inflammation. Patients often feel discomfort or pain in organs such as the stomach when an attack occurs. In severe cases, other diseases such as neuritis may also occur. Patients with chronic inflammatory demyelination will experience a rapid decline in immunity and a significant degree of damage to their immune system. So, how should chronic inflammatory demyelination be treated?

1. Corticosteroids

It is the first choice for the treatment of CIDP. Commonly used drugs include methylprednisolone, prednisone and dexamethasone. When using hormones, pay attention to calcium and potassium supplements and protect the gastric mucosa.

2. IVIG

IVIG treatment is effective in more than 50% of patients. Some patients experience relief after the first treatment, but most patients require continued treatment. For relapse treatment or maintenance treatment, it is recommended to inject once a month and gradually reduce the dose. To ensure continued improvement in the condition, low-dose prednisone or other immunosuppressants such as cyclophosphamide may be added orally.

3.PE

It can remove immune complexes and related antibodies to reduce the inflammatory damage of peripheral nerves. Nearly half of CIDP patients respond well to PE. Most patients' reactions are temporary and require multiple or regular PE treatments. Treatment of PE is not recommended within 3 weeks of IVIG administration.

4. Immunosuppressive drugs

Immunosuppressants are usually given when other treatments are ineffective. Commonly used drugs include cyclophosphamide, azathioprine, and cyclosporine A.

5. Immunomodulators

Patients with CIDP who do not respond well to corticosteroids, PE, or IVIG may be treated with interferon-α.

6. Other treatments

B vitamins can be used for nerve nutrition treatment, such as vitamin B1, B12, B6, etc.; those who cannot tolerate severe neuralgia can add carbamazepine, gabapentin, pregabalin, etc. for treatment; start neurological function rehabilitation exercises early to prevent muscle atrophy and joint contracture.

In summary, the long-term prognosis of CIDP patients is generally good, especially for patients with a unidirectional or remitting course; in addition, experience suggests that the time from onset to the start of treatment is the key to prognosis, but further research is needed to confirm this.