Chronic Inflammatory Demyelinating Polyneuropathy
Chronic Inflammatory Demyelinating Polyneuropathy
Overview:
Chronic Inflammatory Demyelinating Polyneuropathy is a rare, long-term neurological disorder where the immune system damages the protective covering of nerves, leading to progressive weakness and sensory loss in the arms and legs.
Common Symptoms:
- Gradual muscle weakness
- Numbness or tingling in limbs
- Poor coordination or balance
- Fatigue
Treatments & Procedures:
- Treatment may include intravenous immunoglobulin (IVIG), corticosteroids, or plasma exchange to reduce immune system activity
- Immunosuppressive medications may also be used
- Physical therapy helps maintain strength and mobility
- Nerve conduction studies and EMG for diagnosis
Guillain-Barré Syndrome
Overview:
Guillain-Barré syndrome is a sudden-onset autoimmune condition where the immune system attacks the nerves, often after a viral infection. It can lead to rapid, ascending muscle weakness and even paralysis.
Common Symptoms:
- Weakness starting in the legs and moving upward
- Tingling or numbness
- Difficulty walking or moving arms
- Breathing difficulty in severe cases
Treatments & Procedures:
- Hospital care and monitoring
- IVIG: Healthy antibodies to reduce immune attack
- Plasma exchange: Removes harmful antibodies
- Rehabilitation: Therapy to regain strength and function
- Nerve conduction studies and EMG for diagnosis
Muscle Disorders
Overview:
Muscular disorders are conditions that affect the muscles and can lead to weakness, stiffness, or loss of function. They may be inherited, caused by problems with the immune system, or develop after illness or injury. These disorders can affect people of all ages and may involve different muscle groups throughout the body.
Common Symptoms:
- Muscle weakness
- Trouble walking, climbing stairs, or lifting objects
- Frequent falls or difficulty with balance
- Muscle cramps or stiffness
- Joint tightness or contractures
Treatments & Procedures:
- Physical and occupational therapy to maintain strength and function
- Medications to reduce inflammation or slow disease progression
- Immunotherapy for immune-related muscle conditions
- Mobility aids and supportive devices
- Regular monitoring of heart and lung health
- EMG and other diagnostic tests to evaluate muscle function
Myasthenia Gravis
Overview:
Myasthenia gravis is a chronic autoimmune disorder where the body’s immune system attacks the connection between nerves and muscles, leading to muscle weakness. It often affects muscles that control the eyes, face, swallowing, and breathing.
Common Symptoms:
- Muscle weakness that worsens with activity
- Drooping eyelids
- Difficulty swallowing or speaking
- Shortness of breath
Treatments & Procedures:
Neurodiagnostics
- Nerve conduction studies and electromyography (EMG) to evaluate nerve-muscle communication
- Blood tests to detect antibodies, including acetylcholine receptor (AChR) antibodies
Neurology
- Medications to improve nerve-muscle signaling and manage immune activity, such as acetylcholinesterase inhibitors, corticosteroids, and other immunosuppressive therapies
- Intravenous immunoglobulin (IVIG) to reduce harmful immune responses during symptom flare-ups
- Plasma exchange (plasmapheresis) to remove antibodies that interfere with nerve-muscle communication
- Neurology-led care coordination and ongoing monitoring to adjust treatment and manage symptoms over time
- Lifestyle and symptom management guidance, including balancing activity with rest and avoiding triggers such as stress or extreme heat
Thoracic Surgery
- Thymectomy (surgical removal of the thymus gland), often performed by a thoracic surgeon, to reduce symptoms in selected patients
Peripheral Nerve Disorders
Peripheral Nerve Disorders
Overview:
Peripheral nerve disorders involve damage, irritation, or compression of the nerves outside the brain and spinal cord. These conditions can result from injury, diabetes, autoimmune diseases, infections, or physical pressure on a nerve.
Common Symptoms:
- Tingling or numbness
- Burning or sharp pain
- Muscle weakness
- Loss of balance or coordination
- Sensitivity to touch
Treatments & Procedures:
- Addressing underlying causes (such as diabetes management or treating infection)
- Pain management medications
- Physical therapy and rehabilitation
- IVIG or plasma exchange for immune-related nerve conditions
- Nerve decompression or repair surgery in select cases
- Nerve conduction studies and EMG for diagnosis
We've highlighted some of the most common services—please explore the conditions list for treatments by condition.
Botox for Spasticity
Overview:
Botox therapy is an injectable treatment used to relax muscles that are too tight or stiff, a condition called spasticity. Spasticity can happen after a stroke, brain injury, spinal cord injury, or with certain neurological conditions like multiple sclerosis. Botox helps reduce muscle stiffness, improve comfort, and make movement or therapy easier.
Conditions Treated
- Stroke-related muscle stiffness
- Multiple sclerosis (MS)
- Cerebral palsy
- Spinal cord injury
- Brain injury
Before the Procedure
Your neurologist will examine which muscles are affected and may use an ultrasound or electrical signal test to find the right injection sites. You don’t need special preparation, but it helps to wear loose, comfortable clothing. Let your care team know about any medications, allergies, or recent infections. The procedure is usually done in the clinic and takes about 15 to 30 minutes.
After the Procedure
You can return home right after your appointment and resume normal activities. The treated muscles may feel sore for a short time. Most patients start to notice smoother movement and less stiffness within one to two weeks. The results usually last about three months, and repeat treatments can be scheduled as needed. Your care team may also recommend physical or occupational therapy to help you get the best results.
Electromyography
Overview:
Electromyography measures the electrical activity of your muscles to help diagnose nerve and muscle disorders such as neuropathy or myopathy.
Before the Procedure:
You may be asked to avoid certain medications that affect muscle or nerve activity. Be sure to inform your provider about any blood thinners or implanted devices.
After the Procedure:
The test may cause brief discomfort from small needle electrodes, but symptoms typically resolve quickly. Most people can return to normal activities right away. Mild muscle soreness at the test sites may occur.
IVIG (Intravenous Immunoglobulin) Therapy
IVIG (Intravenous Immunoglobulin) Therapy
Overview:
IVIG therapy uses healthy antibodies from donated blood to help calm an overactive immune system. It can reduce inflammation and help your body stop attacking its own nerves. IVIG is given through an IV infusion in the arm, usually over several hours.
Conditions Treated
- Guillain-Barré syndrome (GBS)
- Chronic inflammatory demyelinating polyneuropathy (CIDP)
- Myasthenia gravis
- Multiple sclerosis (in some cases)
- Autoimmune encephalitis
Before the Treatment:
IVIG is usually given as an outpatient infusion, lasting several hours. You may be asked to hydrate well and eat beforehand. Let your care team know about any prior reactions to infusions.
After the Treatment:
You’ll be monitored for side effects, which may include fatigue, headache, or mild flu-like symptoms. Most people tolerate IVIG well and can return to regular activities shortly after treatment. Multiple sessions may be scheduled depending on your condition.
Medication Management
Overview:
Medication management involves carefully selecting, adjusting, and monitoring medicines to help manage symptoms and improve quality of life. The goal is to make sure each medication is safe, effective, and tailored to your needs while limiting side effects or interactions.
Before the Treatment:
Your care provider will review your medical history, current medications, and symptoms to create a personalized plan. In some cases, lab tests or other evaluations may be ordered to guide treatment decisions.
After the Treatment:
You’ll have regular follow-up appointments to track how well your medications are working and to adjust doses if needed. Your care team will also check for side effects and answer any questions to help you stay safe and feel your best.
Nerve Conduction Studies
Overview:
Nerve Conduction Studies measure how quickly electrical signals travel through your nerves. This test helps diagnose nerve damage or dysfunction.
Before the Treatment:
No special preparation is usually needed.
After the Treatment:
After the test, you can resume normal activities. Some people may feel brief discomfort during the test.
Plasma Exchange
Overview:
Plasma exchange, also known as Plasmapheresis, removes and replaces the liquid part of your blood (plasma) to get rid of harmful antibodies that attack the nervous system. This helps reduce inflammation and improve strength, vision, or other symptoms caused by immune-related nerve conditions.
Conditions Treated
- Guillain-Barré syndrome (GBS)
- Myasthenia gravis
- Neuromyelitis optica (NMO)
- Autoimmune encephalitis
- Certain forms of multiple sclerosis
Before the Treatment:
Your care team will review your blood tests and place a special IV line, often in your neck or chest, to allow the machine to filter your blood. The procedure takes about two to three hours. You may receive medications to prevent side effects like low blood pressure or cramping.
After the Treatment:
You can usually go home the same day unless you are already in the hospital. Mild fatigue or lightheadedness is common and should improve with rest and hydration. Your doctor will decide how many treatments you need—often several sessions over one to two weeks.
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