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Pain and Therapy
Published in: Pain and Therapy 2/2019

Open Access 01-12-2019 | Neuropathic Pain | Review

Pain in Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Systematic Review and Meta-Analysis

Authors: Athena Michaelides, Robert D. M. Hadden, Ptolemaios G. Sarrigiannis, Marios Hadjivassiliou, Panagiotis Zis

Published in: Pain and Therapy | Issue 2/2019

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Abstract

Introduction

Although chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) predominantly affects large myelinated fibers, many patients have pain. The aim of this paper is to systematically review the current literature regarding CIDP with a particular focus on epidemiological and clinical characteristics of painful CIDP.

Methods

A systematic literature search was conducted on PubMed database.

Results

Our search strategy identified 146 articles. Thirty-eight papers, reporting on 991 patients, met the inclusion criteria and were used for this review. The pooled estimate of the prevalence of pain at any point within the course of CIDP was 46% (95% CI 36–57%). Immune treatment of CIDP might be adequate as monotherapy for the management of pain. Treatment specific to pain currently shows effectiveness as adjuvant treatment when CIDP is treated and pain persists.

Conclusions

Pain in CIDP is an underexplored field. Future research should focus on the natural history, phenomenology, and management of pain in CIDP.
Literature
1.
2.
3.
4.
Zis P, Sarrigiannis PG, Rao DG, Hewamadduma C, Hadjivassiliou M. Chronic idiopathic axonal polyneuropathy: a systematic review. J Neurol. 2016;263(10):1903–10.PubMed
5.
6.
Brozou V, Vadalouca A, Zis P. Pain in platin-induced neuropathies: a systematic review and meta-analysis. Pain Ther. 2018;7(1):105–19.PubMed
7.
Zis P, Sarrigiannis PG, Rao DG, Hadjivassiliou M. Gluten neuropathy: prevalence of neuropathic pain and the role of gluten-free diet. J Neurol. 2018;265(10):2231–6.PubMed
8.
Adewusi JK, Hadjivassiliou M, Vinagre-Aragón A, O’Connor KR, Khan A, Grünewald RA, Zis P. Peripheral neuropathic pain in idiopathic Parkinson’s disease: prevalence and impact on quality of life; a case-controlled study. J Neurol Sci. 2018;15(392):3–7.
9.
Adewusi JK, Hadjivassiliou M, Vinagre-Aragón A, O’Connor KR, Khan A, Grünewald RA, Zis P. Sensory neuropathic symptoms in idiopathic Parkinson’s disease: prevalence and impact on quality of life. Acta Neurol Belg. 2018;118(3):445–50.PubMed
10.
Zis P, Grünewald RA, Chaudhuri RK, Hadjivassiliou M. Peripheral neuropathy in idiopathic Parkinson’s disease: a systematic review. J Neurol Sci. 2017;15(378):204–9.
11.
Zis P, Paladini A, Piroli A, McHugh PC, Varrassi G, Hadjivassiliou M. Pain as a first manifestation of paraneoplastic neuropathies: a systematic review and meta-analysis. Pain Ther. 2017;6(2):143–51.PubMedPubMedCentral
12.
13.
Artemiadis AK, Zis P. Neuropathic pain in acute and subacute neuropathies: a systematic review. Pain Physician. 2018;21(2):111–20.PubMed
14.
Vallat JM, Sommer C, Magy L. Chronic inflammatory demyelinating polyradiculoneuropathy: diagnostic and therapeutic challenges for a treatable condition. Lancet Neurol. 2010;9(4):402–12.PubMed
15.
16.
Kacar A, Bjelica B, Bozovic I, Peric S, Nikolic A, Cobeljic M, et al. Neuromuscular disease-specific questionnaire to assess quality of life in patients with chronic inflammatory demyelinating polyradiculoneuropathy. J Peripher Nerv Syst. 2018;23(1):11–6.PubMed
17.
Liewluck T, Engelstad JK, Mauermann ML. Immunotherapy-responsive allodynia due to distal acquired demyelinating symmetric (DADS) neuropathy. Muscle Nerve. 2016;54(5):973–7.PubMed
18.
Bäumer D, Grant DJ, Knight R, Buckley C, Bennett D, Rinaldi S. CIDP presenting as recurrent severe back pain without weakness or sensory loss. Pract Neurol. 2016;16(6):488–92.PubMed
19.
Lin K-Y, Wang I-H, Jou J-R, Chu H-J, Wei W, Lee S-H. Bilateral optic neuritis related to chronic inflammatory demyelinating polyneuropathy. Taiwan J Ophthalmol [Internet]. 2015;5(1):40–3.PubMed
20.
Kuitwaard K, Hahn AF, Vermeulen M, Venance SL, Van Doorn PA. Intravenous immunoglobulin response in treatment-naïve chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Neurosurg Psychiatry. 2015;86(12):1331–6.PubMed
21.
dos Santos PL, Barreira AA, de Almeida-Ribeiro GAN, Marques Junior W, Silva DMD. Chronic inflammatory demyelinating polyneuropathy: quality of life, sociodemographic profile and physical complaints. Arq Neuropsiquiatr. 2014;72(3):179–83.PubMed
22.
Nasu S, Misawa S, Sekiguchi Y, Shibuya K, Kanai K, Fujimaki Y, et al. Different neurological and physiological profiles in POEMS syndrome and chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry. 2012;83(5):476–9.PubMed
23.
Rajabally YA, Chavada G. Lewis-Sumner syndrome of pure upper-limb onset: diagnostic, prognostic, and therapeutic features. Muscle Nerve. 2009;39(2):206–20.PubMed
24.
Boukhris S, Magy L, Khalil M, Sindou P, Vallat JM. Pain as the presenting symptom of chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). J Neurol Sci. 2007;254(1–2):33–8.PubMed
25.
Boukhris S, Magy L, Gallouedec G, Khalil M, Couratier P, Gil J, et al. Fatigue as the main presenting symptom of chronic inflammatory demyelinating polyradiculoneuropathy: a study of 11 cases. J Peripher Nerv Syst. 2005;10(3):329–37.PubMed
26.
Pytel P, Rezania K, Soliven B, Frank J, Wollmann R. Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with hypertrophic spinal radiculopathy mimicking neurofibromatosis. Acta Neuropathol [Internet]. 2003;105(2):185–8.PubMed
27.
Gorson Chaudhry V. Polyneuropathy chronic inflammatory demyelinating. Curr Treat Options Neurol. 1999;1(3):251–62.PubMed
28.
Lewis RA, Sumner AJ, Brown MJ, Asbury AK. Multifocal demyelinating neuropathy with persistent conduction block. Neurology. 1982;32(9):958–64.PubMed
29.
Gorson K, Ropper AH, Weinberg DH. Upper limb predominant, multifocal chronic inflammatory. Muscle Nerve. 1999;22(6):758–65.PubMed
30.
Franssen H, Van den Berg LH, Van den Berg-Vos RM, Oh SJ, Wokke JHJ. Multifocal inflammatory demyelinating neuropathy: a distinct clinical entity? Neurology. 2012;55(5):735–42.
31.
Misra VP, Walker RWH. Acute-onset painful upper limb multifocal demyelinating motor neuropathy. J Neurol. 2000;247(12):949–54.PubMed
32.
Viala K, Renié L, Maisonobe T, Béhin A, Neil J, Léger JM, et al. Follow-up study and response to treatment in 23 patients with Lewis–Sumner syndrome. Brain. 2004;127(9):2010–7.PubMed
33.
de Freitas MRG, Nascimento OJM, Domingues RC, Soares CN, Brito AR. Chronic inflammatory demyelinating polyradiculoneuropathy: two cases with cervical spinal cord compression. Arq Neuropsiquiatr. 2006;63(3a):666–9.
34.
Tataroglu C, Ozkul A, Sair A. Chronic inflammatory demyelinating polyneuropathy and respiratory failure due to phrenic nerve involvement. Clinical neuromuscular disease. J Clin Neuromuscul Dis [Internet]. 2010;12(1):42–6.PubMed
35.
Leitch MM, Sherman WH, Brannagan TH. Distal acquired demyelinating symmetric polyneuropathy progressing to classic chronic inflammatory demyelinating polyneuropathy and response to fludarabine and cyclophosphamide. Muscle Nerve. 2013;47(2):292–6.PubMed
36.
Ayrignac X, Viala K, Koutlidis RM, Taïeb G, Stojkovic T, Musset L, et al. Sensory chronic inflammatory demyelinating polyneuropathy: an under-recognized entity? Muscle Nerve. 2013;48(5):727–32.PubMed
37.
Ram Ayyar D, Bradley WG, Rotta FT, Sussman AT, Shebert RT, Sharma KR. The spectrum of chronic inflammatory demyelinating polyneuropathy. J Neurol Sci. 2002;173(2):129–39.
38.
Berger AR, Herskovitz S, Kaplan J. Late motor involvement in cases presenting as “chronic sensory demyelinating polyneuropathy”. Muscle Nerve. 1995;18(4):440–4.PubMed
39.
Dyck PJB, Spinner RJ, Klein CJ, Daube JR, Sinnreich M, Engelstad J. Chronic immune sensory polyradiculopathy: a possibly treatable sensory ataxia. Neurology. 2012;63(9):1662–9.
40.
Li Y, Thammongkolchai T, Suhaib O, Katirji B, Termsarasab P. Chronic immune sensorimotor polyradiculopathy (CISMP): report of a case series. Muscle Nerve. 2019;59(6):658–64.PubMed
41.
42.
Morrison KE, Davies PTG. Chronic inflammatory demyelinating polyneuropathy presenting with headache and papilledema. Headache. 1999;39(4):299–300.PubMed
43.
Oh SJ, Joy JL, Kuruoglu R. “Chronic sensory demyelinating neuropathy”: chronic inflammatory demyelinating polyneuropathy presenting as a pure sensory neuropathy. J Neurol Neurosurg Psychiatry. 1992;55(8):677–80.PubMedPubMedCentral
44.
Ginsberg L, Platts AD, Thomas PK. Chronic inflammatory demyelinating polyneuropathy mimicking a lumbar spinal stenosis syndrome. J Neurol Neurosurg Psychiatry. 1995;59(2):189–91.PubMedPubMedCentral
45.
King RH, Lecky BR, Schady W, Goulding PJ, Smith CM. Massive nerve root enlargement in chronic inflammatory demyelinating polyneuropathy. J Neurol Neurosurg Psychiatry. 2008;61(6):636–40.
46.
McCobe PA, Pollard JD, McLeod JG. Chronic inflammatory demyelinating polyradiculoneuropathy: a clinical and electrophysiological study of 92 cases. Brain. 1987;6:1617–30.
47.
Goldstein JM, Parks BJ, Mayer PL, Kim JH, Sze G, Miller RG. Nerve root hypertrophy as the cause of lumbar stenosis in chronic inflammatory demyelinating polyradiculoneuropathy. Muscle Nerve. 1996;19(7):892–6.PubMed
48.
Shah S, Chandrashekar H, Manji H, Davagnanam I. Cranial nerve, spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy. Pract Neurol. 2012;12(1):68–9.PubMed
49.
Yang F, Thompson EO, Soper JR, McLeod JG, Davies L, Pollard JD, et al. Spinal root and plexus hypertrophy in chronic inflammatory demyelinating polyneuropathy. Brain. 2002;122(7):1383–90.
50.
Simmons Z, Albers JW, Bromberg MB, Feldman EL. Presentation and initial clinical course in patients with chronic inflammatory demyelinating polyradiculoneuropathy: comparison of patients without and with monoclonal gammopathy. Neurology. 2012;43(11):2202.
51.
Kuitwaard K, Bos-Eyssen ME, Blomkwist-Markens PH, van Doorn PA. Recurrences, vaccinations and long-term symptoms in GBS and CIDP. J Peripher Nerv Syst. 2009;14:310–5.PubMed
52.
Simmons Z, Wald JJ, Albers JW. Chronic inflammatory demyelinating polyradiculoneuropathy in children: I. Presentation, electrodiagnostic studies, and initial clinical course, with comparison to adults. Muscle Nerve. 1997;20(8):1008–15.PubMed
53.
54.
Freynhagen R, Baron R, Gockel U, Tölle TR. painDETECT: a new screening questionnaire to identify neuropathic components in patients with back pain. Curr Med Res Opin. 2006;22(10):1911–20.
55.
Bouhassira D, Attal N, Alchaar H, Boureau F, Brochet B, Bruxelle J, Cunin G, Fermanian J, Ginies P, Grun-Overdyking A, Jafari-Schluep H, Lantéri-Minet M, Laurent B, Mick G, Serrie A, Valade D, Vicaut E. Comparison of pain syndromes associated with nervous or somatic lesions and development of a new neuropathic pain diagnostic questionnaire (DN4). Pain. 2005;114(1–2):29–36.PubMed
56.
Ormerod IE, Waddy HM, Kermode AG, Murray NM, Thomas PK. Involvement of the central nervous system in chronic inflammatory demyelinating polyneuropathy: a clinical, electrophysiological and magnetic resonance imaging study. J Neurol Neurosurg Psychiatry. 1990;53(9):789–93.PubMedPubMedCentral
Metadata
Title
Pain in Chronic Inflammatory Demyelinating Polyradiculoneuropathy: A Systematic Review and Meta-Analysis
Authors
Athena Michaelides
Robert D. M. Hadden
Ptolemaios G. Sarrigiannis
Marios Hadjivassiliou
Panagiotis Zis
Publication date
01-12-2019
Publisher
Springer Healthcare
Published in
Pain and Therapy / Issue 2/2019
Print ISSN: 2193-8237
Electronic ISSN: 2193-651X
DOI
https://doi.org/10.1007/s40122-019-0128-y

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