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Distinguishing acute-onset CIDP from Guillain–Barré syndrome with treatment related fluctuations

From the Department of Neurology, Erasmus MC, Rotterdam, The Netherlands.

Address correspondence and reprint requests to Dr. Liselotte Ruts, Erasmus MC (Faculty), Department of Neurology, Room Ee-2230, PO Box 1738, 3000 DR Rotterdam, The Netherlands; e-mail: l.ruts{at}erasmusmc.nl

Guillain–Barré syndrome (GBS) patients may worsen after initial treatment (treatment-related fluctuation [TRF]). It is difficult to distinguish GBS-TRF from chronic inflammatory demyelinating polyneuropathy with acute onset (A-CIDP). The authors compared 13 patients with A-CIDP with 11 patients with GBS-TRF and concluded that A-CIDP should be suspected when a patient with GBS deteriorates after 9 weeks from onset or when deterioration occurs three times or more. Maintenance treatment should then be considered.

Received December 16, 2004. Accepted in final form March 28, 2005.

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