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category: "Brain"
documentVersionId: "96729e13-6c4b-4fd3-be3e-4e1a940566fd"
imageCount: 12
isBookmarked: false
isComparable: true
isInCompareCart: false
lastUpdated: "06/08/20"
pageDescription: "CIDP"
pageKeywords: "Brain, Diagnosis, Pathology-Based Diagnoses, Infectious, Inflammatory, and Demyelinating Disease, Inflammatory and Demyelinating Disease, CIDP"
pageTitle: "CIDP | STATdx"
enhancedTitle: "CIDP"
type: "DX"
references: true
breadcrumbs:
- "Brain"
- "Diagnosis"
@@ -275,39 +273,111 @@ breadcrumbs:
0f953548-b230-4137-9147-51d6ed147c6c
## References
# Selected References
1. [Campagnolo M et al: Sporadic hereditary neuropathies misdiagnosed as chronic inflammatory demyelinating polyradiculoneuropathy: Pitfalls and red flags. J Peripher Nerv Syst. 25(1):19-26, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=31919945%5Bpmid%5D)
1. [Van den Bergh PYK et al: Boundaries of chronic inflammatory demyelinating polyradiculoneuropathy. J Peripher Nerv Syst. 25(1):4-8, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=31981273%5Bpmid%5D)
1. [Wu F et al: MR neurography of lumbosacral nerve roots: diagnostic value in chronic inflammatory demyelinating polyradiculoneuropathy and correlation with electrophysiological parameters. Eur J Radiol. 124:108816, 2020](http://www.ncbi.nlm.nih.gov/pubmed/?term=31923808%5Bpmid%5D)
1. [Suanprasert N et al: Polyneuropathies and chronic inflammatory demyelinating polyradiculoneuropathy in multiple sclerosis. Mult Scler Relat Disord. 30:284-90, 2019](http://www.ncbi.nlm.nih.gov/pubmed/?term=30870805%5Bpmid%5D)
1. [Pitarokoili K et al: High-resolution nerve ultrasound and magnetic resonance neurography as complementary neuroimaging tools for chronic inflammatory demyelinating polyneuropathy. Ther Adv Neurol Disord. 11:1756286418759974, 2018](http://www.ncbi.nlm.nih.gov/pubmed/?term=29552093%5Bpmid%5D)
1. [Ishikawa T et al: MR neurography for the evaluation of CIDP. Muscle Nerve. 55(4):483-9, 2017](http://www.ncbi.nlm.nih.gov/pubmed/?term=27500391%5Bpmid%5D)
1. [Kronlage M et al: Large coverage MR neurography in CIDP: diagnostic accuracy and electrophysiological correlation. J Neurol. 264(7):1434-43, 2017](http://www.ncbi.nlm.nih.gov/pubmed/?term=28620719%5Bpmid%5D)
1. [Kronlage M et al: Diffusion tensor imaging in chronic inflammatory demyelinating polyneuropathy: diagnostic accuracy and correlation with electrophysiology. Invest Radiol. 52(11):701-7, 2017](http://www.ncbi.nlm.nih.gov/pubmed/?term=28574858%5Bpmid%5D)
1. [Said G et al: Chronic inflammatory demyelinative polyneuropathy. Handb Clin Neurol. 115:403-13, 2013](http://www.ncbi.nlm.nih.gov/pubmed/?term=23931792%5Bpmid%5D)
1. [Mahdi-Rogers M et al: Overview of the pathogenesis and treatment of chronic inflammatory demyelinating polyneuropathy with intravenous immunoglobulins. Biologics. 4:45-9, 2010](http://www.ncbi.nlm.nih.gov/pubmed/?term=20376173%5Bpmid%5D)
1. [Tracy JA et al: Investigations and treatment of chronic inflammatory demyelinating polyradiculoneuropathy and other inflammatory demyelinating polyneuropathies. Curr Opin Neurol. 23(3):242-8, 2010](http://www.ncbi.nlm.nih.gov/pubmed/?term=20389243%5Bpmid%5D)
1. [Vallat JM et al: Chronic inflammatory demyelinating polyradiculoneuropathy: diagnostic and therapeutic challenges for a treatable condition. Lancet Neurol. 9(4):402-12, 2010](http://www.ncbi.nlm.nih.gov/pubmed/?term=20298964%5Bpmid%5D)
1. [Van den Bergh PY et al: European Federation of Neurological Societies/Peripheral Nerve Society guideline on management of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force of the European Federation of Neurological Societies and the Peripheral Nerve Society - first revision. Eur J Neurol. 17(3):356-63, 2010](http://www.ncbi.nlm.nih.gov/pubmed/?term=20456730%5Bpmid%5D)
1. [Brannagan TH 3rd: Current treatments of chronic immune-mediated demyelinating polyneuropathies. Muscle Nerve. 39(5):563-78, 2009](http://www.ncbi.nlm.nih.gov/pubmed/?term=19301378%5Bpmid%5D)
1. [Laughlin RS et al: Incidence and prevalence of CIDP and the association of diabetes mellitus. Neurology. 73(1):39-45, 2009](http://www.ncbi.nlm.nih.gov/pubmed/?term=19564582%5Bpmid%5D)
1. [Tazawa K et al: Spinal nerve root hypertrophy on MRI: clinical significance in the diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy. Intern Med. 47(23):2019-24, 2008](http://www.ncbi.nlm.nih.gov/pubmed/?term=19043253%5Bpmid%5D)
1. [Tsuchiya K et al: Demonstration of spinal cord and nerve root abnormalities by diffusion neurography. J Comput Assist Tomogr. 32(2):286-90, 2008](http://www.ncbi.nlm.nih.gov/pubmed/?term=18379319%5Bpmid%5D)
1. [Said G: Chronic inflammatory demyelinating polyneuropathy. Neuromuscul Disord. 16(5):293-303, 2006](http://www.ncbi.nlm.nih.gov/pubmed/?term=16631367%5Bpmid%5D)
1. [Köller H et al: Chronic inflammatory demyelinating polyneuropathy--update on pathogenesis, diagnostic criteria and therapy. Curr Opin Neurol. 18(3):273-8, 2005](http://www.ncbi.nlm.nih.gov/pubmed/?term=15891411%5Bpmid%5D)
1. [Matsuoka N et al: Detection of cervical nerve root hypertrophy by ultrasonography in chronic inflammatory demyelinating polyradiculoneuropathy. J Neurol Sci. 219(1-2):15-21, 2004](http://www.ncbi.nlm.nih.gov/pubmed/?term=15050432%5Bpmid%5D)
1. [Cocito D et al: Different clinical, electrophysiological and immunological features of CIDP associated with paraproteinaemia. Acta Neurol Scand. 108(4):274-80, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12956862%5Bpmid%5D)
1. [Fee DB et al: Resolution of chronic inflammatory demyelinating polyneuropathy-associated central nervous system lesions after treatment with intravenous immunoglobulin. J Peripher Nerv Syst. 8(3):155-8, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12904236%5Bpmid%5D)
1. [Haq RU et al: Chronic inflammatory demyelinating polyradiculoneuropathy in diabetic patients. Muscle Nerve. 27(4):465-70, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12661048%5Bpmid%5D)
1. [Magda P et al: Comparison of electrodiagnostic abnormalities and criteria in a cohort of patients with chronic inflammatory demyelinating polyneuropathy. Arch Neurol. 60(12):1755-9, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=14676052%5Bpmid%5D)
1. [Odaka M et al: Patients with chronic inflammatory demyelinating polyneuropathy initially diagnosed as Guillain-Barre syndrome. J Neurol. 250(8):913-6, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12928908%5Bpmid%5D)
1. [Oguz B et al: Diffuse spinal and intercostal nerve involvement in chronic inflammatory demyelinating polyradiculoneuropathy: MRI findings. Eur Radiol. 13 Suppl 4:L230-4, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=15018192%5Bpmid%5D)
1. [Press R et al: Aberrated levels of cerebrospinal fluid chemokines in Guillain-Barre syndrome and chronic inflammatory demyelinating polyradiculoneuropathy. J Clin Immunol. 23(4):259-67, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12959218%5Bpmid%5D)
1. [Rodriguez-Casero MV et al: Childhood chronic inflammatory demyelinating polyneuropathy with central nervous system demyelination resembling multiple sclerosis. Neuromuscul Disord. 13(2):158-61, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12565914%5Bpmid%5D)
1. [Ropper AH: Current treatments for CIDP. Neurology. 60(8 Suppl 3):S16-22, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12707418%5Bpmid%5D)
1. [Saperstein DS et al: Current concepts and controversy in chronic inflammatory demyelinating polyneuropathy. Curr Neurol Neurosci Rep. 3(1):57-63, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12507413%5Bpmid%5D)
1. [Toyka KV et al: The pathogenesis of CIDP: rationale for treatment with immunomodulatory agents. Neurology. 60(8 Suppl 3):S2-7, 2003](http://www.ncbi.nlm.nih.gov/pubmed/?term=12707416%5Bpmid%5D)
1. [Costello F et al: Childhood-onset chronic inflammatory demyelinating polyradiculoneuropathy with cranial nerve involvement. J Child Neurol. 17(11):819-23, 2002](http://www.ncbi.nlm.nih.gov/pubmed/?term=12585721%5Bpmid%5D)
1. Cros D: Peripheral Neuropathy. 1st ed. Philadelphia: Lippincott Williams & Wilkins: 432, 2001
1. [Sabatelli M et al: Pure motor chronic inflammatory demyelinating polyneuropathy. J Neurol. 248(9):772-7, 2001](http://www.ncbi.nlm.nih.gov/pubmed/?term=11596782%5Bpmid%5D)
1. [Saperstein DS et al: Clinical spectrum of chronic acquired demyelinating polyneuropathies. Muscle Nerve. 24(3):311-24, 2001](http://www.ncbi.nlm.nih.gov/pubmed/?term=11353415%5Bpmid%5D)
1. [Taniguchi N et al: Sonographic detection of diffuse peripheral nerve hypertrophy in chronic inflammatory demyelinating polyradiculoneuropathy. J Clin Ultrasound. 28(9):488-91, 2000](http://www.ncbi.nlm.nih.gov/pubmed/?term=11056027%5Bpmid%5D)
1. [Van den Bergh PY et al: Chronic demyelinating hypertrophic brachial plexus neuropathy. Muscle Nerve. 23(2):283-8, 2000](http://www.ncbi.nlm.nih.gov/pubmed/?term=10639625%5Bpmid%5D)
1. [Duarte J et al: Hypertrophy of multiple cranial nerves and spinal roots in chronic inflammatory demyelinating neuropathy. J Neurol Neurosurg Psychiatry. 67(5):685-7, 1999](http://www.ncbi.nlm.nih.gov/pubmed/?term=10519883%5Bpmid%5D)
1. [Midroni G et al: MRI of the cauda equina in CIDP: clinical correlations. J Neurol Sci. 170(1):36-44, 1999](http://www.ncbi.nlm.nih.gov/pubmed/?term=10540034%5Bpmid%5D)
1. [Mizuno K et al: Chronic inflammatory demyelinating polyradiculoneuropathy with diffuse and massive peripheral nerve hypertrophy: distinctive clinical and magnetic resonance imaging features. Muscle Nerve. 21(6):805-8, 1998](http://www.ncbi.nlm.nih.gov/pubmed/?term=9585338%5Bpmid%5D)
1. [Kuwabara S et al: Magnetic resonance imaging at the demyelinative foci in chronic inflammatory demyelinating polyneuropathy. Neurology. 48(4):874-7, 1997](http://www.ncbi.nlm.nih.gov/pubmed/?term=9109870%5Bpmid%5D)
1. [Simmons Z et al: Chronic inflammatory demyelinating polyradiculoneuropathy in children: I. Presentation, electrodiagnostic studies, and initial clinical course, with comparison to adults. 20(12):1569-75, 1997](http://www.ncbi.nlm.nih.gov/pubmed/?term=9390670%5Bpmid%5D)
1. [Van Es HW et al: Magnetic resonance imaging of the brachial plexus in patients with multifocal motor neuropathy. Neurology. 48(5):1218-24, 1997](http://www.ncbi.nlm.nih.gov/pubmed/?term=9153446%5Bpmid%5D)
## Images
### Selected Images
![Sagittal T1 C+ MR of the cervical spine shows marked hypertrophy and enhancement of all exiting cervical nerve roots <img src='/img/arrows/CS.png'/>. 5 mm is considered an adequate cut-off value of cervical spinal nerve root diameter, discriminating CIDP from controls. Mean diameter of spinal nerve roots in CIDP: Cervical 6-6.8 mm; lumbosacral 7.3-10.4 mm.](images/app.statdx.com_image_thumbnail_e0d1598d-4a92-4d78-9124-87f27a196230_annotated_true_size_900_quality_90_8ebe0b28_20251018T122453Z.jpg)
*Sagittal T1 C+ MR of the cervical spine shows marked hypertrophy and enhancement of all exiting cervical nerve roots <img src='/img/arrows/CS.png'/>. 5 mm is considered an adequate cut-off value of cervical spinal nerve root diameter, discriminating CIDP from controls. Mean diameter of spinal nerve roots in CIDP: Cervical 6-6.8 mm; lumbosacral 7.3-10.4 mm.*
![Sagittal T1 C+ MR of the cervical spine shows marked hypertrophy and enhancement of all exiting cervical nerve roots <img src='/img/arrows/CS.png'/>. 5 mm is considered an adequate cut-off value of cervical spinal nerve root diameter, discriminating CIDP from controls. Mean diameter of spinal nerve roots in CIDP: Cervical 6-6.8 mm; lumbosacral 7.3-10.4 mm.](images/app.statdx.com_image_thumbnail_e0d1598d-4a92-4d78-9124-87f27a196230_size_168_quality_85_41f53f54_20251018T095234Z.jpg)
*Sagittal T1 C+ MR of the cervical spine shows marked hypertrophy and enhancement of all exiting cervical nerve roots <img src='/img/arrows/CS.png'/>. 5 mm is considered an adequate cut-off value of cervical spinal nerve root diameter, discriminating CIDP from controls. Mean diameter of spinal nerve roots in CIDP: Cervical 6-6.8 mm; lumbosacral 7.3-10.4 mm.*
![Sagittal T1 C+ MR of the cervical spine shows marked hypertrophy and enhancement of all exiting cervical nerve roots <img src='/img/arrows/CS.png'/>. 5 mm is considered an adequate cut-off value of cervical spinal nerve root diameter, discriminating CIDP from controls. Mean diameter of spinal nerve roots in CIDP: Cervical 6-6.8 mm; lumbosacral 7.3-10.4 mm.](images/app.statdx.com_image_thumbnail_e0d1598d-4a92-4d78-9124-87f27a196230_size_174_quality_85_02106d72_20251018T095217Z.jpg)
![Sagittal T1 C+ MR of the cervical spine shows marked hypertrophy and enhancement of all exiting cervical nerve roots <img src='/img/arrows/CS.png'/>. 5 mm is considered an adequate cut-off value of cervical spinal nerve root diameter, discriminating CIDP from controls. Mean diameter of spinal nerve roots in CIDP: Cervical 6-6.8 mm; lumbosacral 7.3-10.4 mm.](images/app.statdx.com_image_thumbnail_e0d1598d-4a92-4d78-9124-87f27a196230_size_174_quality_85_90acc783_20251018T122441Z.jpg)
*Sagittal T1 C+ MR of the cervical spine shows marked hypertrophy and enhancement of all exiting cervical nerve roots <img src='/img/arrows/CS.png'/>. 5 mm is considered an adequate cut-off value of cervical spinal nerve root diameter, discriminating CIDP from controls. Mean diameter of spinal nerve roots in CIDP: Cervical 6-6.8 mm; lumbosacral 7.3-10.4 mm.*
![Sagittal T2WI MR reveals enlargement and T2 hyperintensity of exiting extradural lumbosacral nerves <img src='/img/arrows/CS.png'/>. High signal of CSF should be excluded while measuring nerve root size/area in T2 MR.](images/app.statdx.com_image_thumbnail_c27b3469-6c6e-4d3c-8cc8-a93671c5bf09_annotated_true_size_900_quality_90_ac6a09e4_20251018T122453Z.jpg)
*Sagittal T2WI MR reveals enlargement and T2 hyperintensity of exiting extradural lumbosacral nerves <img src='/img/arrows/CS.png'/>. High signal of CSF should be excluded while measuring nerve root size/area in T2 MR.*
![Sagittal T2WI MR reveals enlargement and T2 hyperintensity of exiting extradural lumbosacral nerves <img src='/img/arrows/CS.png'/>. High signal of CSF should be excluded while measuring nerve root size/area in T2 MR.](images/app.statdx.com_image_thumbnail_c27b3469-6c6e-4d3c-8cc8-a93671c5bf09_size_168_quality_85_8455ce81_20251018T095234Z.jpg)
*Sagittal T2WI MR reveals enlargement and T2 hyperintensity of exiting extradural lumbosacral nerves <img src='/img/arrows/CS.png'/>. High signal of CSF should be excluded while measuring nerve root size/area in T2 MR.*
![Axial T1WI C+ MR depicts enlargement and abnormal enhancement of exiting extradural lumbosacral nerves <img src='/img/arrows/CS.png'/>. Blood-nerve barrier breakdown can cause contrast enhancement. Axon loss associated with demyelination is the most important factor of disability and resistance to treatment. Root hypertrophy also may cause stenosis symptoms.](images/app.statdx.com_image_thumbnail_f40f3c68-4a6c-4e61-a1d0-818ea614c071_annotated_true_size_900_quality_90_d99899db_20251018T122453Z.jpg)
*Axial T1WI C+ MR depicts enlargement and abnormal enhancement of exiting extradural lumbosacral nerves <img src='/img/arrows/CS.png'/>. Blood-nerve barrier breakdown can cause contrast enhancement. Axon loss associated with demyelination is the most important factor of disability and resistance to treatment. Root hypertrophy also may cause stenosis symptoms.*
![Axial T1WI C+ MR depicts enlargement and abnormal enhancement of exiting extradural lumbosacral nerves <img src='/img/arrows/CS.png'/>. Blood-nerve barrier breakdown can cause contrast enhancement. Axon loss associated with demyelination is the most important factor of disability and resistance to treatment. Root hypertrophy also may cause stenosis symptoms.](images/app.statdx.com_image_thumbnail_f40f3c68-4a6c-4e61-a1d0-818ea614c071_size_168_quality_85_b4a51382_20251018T095234Z.jpg)
*Axial T1WI C+ MR depicts enlargement and abnormal enhancement of exiting extradural lumbosacral nerves <img src='/img/arrows/CS.png'/>. Blood-nerve barrier breakdown can cause contrast enhancement. Axon loss associated with demyelination is the most important factor of disability and resistance to treatment. Root hypertrophy also may cause stenosis symptoms.*
![Sagittal FLAIR MR demonstrates periventricular ovoid hyperintensities <img src='/img/arrows/CO.png'/> in a typical case of marked fusiform CIDP nerve enlargement with brain demyelination.](images/app.statdx.com_image_thumbnail_8ef8ec72-8984-4f90-8380-953114da6604_annotated_true_size_900_quality_90_c59fe9eb_20251018T122453Z.jpg)
*Sagittal FLAIR MR demonstrates periventricular ovoid hyperintensities <img src='/img/arrows/CO.png'/> in a typical case of marked fusiform CIDP nerve enlargement with brain demyelination.*
![Sagittal FLAIR MR demonstrates periventricular ovoid hyperintensities <img src='/img/arrows/CO.png'/> in a typical case of marked fusiform CIDP nerve enlargement with brain demyelination.](images/app.statdx.com_image_thumbnail_8ef8ec72-8984-4f90-8380-953114da6604_size_168_quality_85_e847b484_20251018T095234Z.jpg)
*Sagittal FLAIR MR demonstrates periventricular ovoid hyperintensities <img src='/img/arrows/CO.png'/> in a typical case of marked fusiform CIDP nerve enlargement with brain demyelination.*
### Additional Images
![Axial T1WI C+ MR shows thickening and enhancement of ventral and dorsal cauda equina nerve roots <img src='/img/arrows/WS.png'/>.](images/app.statdx.com_image_thumbnail_385d96c2-5ef1-466a-bbf7-bcfbf8fb9433_annotated_true_size_900_quality_90_b76815ce_20251018T122453Z.jpg)
*Axial T1WI C+ MR shows thickening and enhancement of ventral and dorsal cauda equina nerve roots <img src='/img/arrows/WS.png'/>.*
![Axial T1WI C+ MR shows thickening and enhancement of ventral and dorsal cauda equina nerve roots <img src='/img/arrows/WS.png'/>.](images/app.statdx.com_image_thumbnail_385d96c2-5ef1-466a-bbf7-bcfbf8fb9433_size_168_quality_85_3828ef00_20251018T095234Z.jpg)
*Axial T1WI C+ MR shows thickening and enhancement of ventral and dorsal cauda equina nerve roots <img src='/img/arrows/WS.png'/>.*
![Sagittal T2WI MR demonstrates diffuse thickening of the intradural cauda equina nerve roots.](images/app.statdx.com_image_thumbnail_e85adcc5-c5d2-4c04-b676-83773765bd8e_annotated_true_size_900_quality_90_6f96bf2d_20251018T122453Z.jpg)
*Sagittal T2WI MR demonstrates diffuse thickening of the intradural cauda equina nerve roots.*
![Sagittal T2WI MR demonstrates diffuse thickening of the intradural cauda equina nerve roots.](images/app.statdx.com_image_thumbnail_e85adcc5-c5d2-4c04-b676-83773765bd8e_size_168_quality_85_0a98e931_20251018T095234Z.jpg)
*Sagittal T2WI MR demonstrates diffuse thickening of the intradural cauda equina nerve roots.*
![Sagittal FLAIR MR of the brain in a CIDP patient shows a typical paraventricular demyelinating lesion <img src='/img/arrows/WS.png'/> similar to those seen in multiple sclerosis patients.](images/app.statdx.com_image_thumbnail_4161f150-8dc2-4c83-94b9-4ee9d01c70f7_annotated_true_size_900_quality_90_b058499e_20251018T122453Z.jpg)
*Sagittal FLAIR MR of the brain in a CIDP patient shows a typical paraventricular demyelinating lesion <img src='/img/arrows/WS.png'/> similar to those seen in multiple sclerosis patients.*
![Sagittal FLAIR MR of the brain in a CIDP patient shows a typical paraventricular demyelinating lesion <img src='/img/arrows/WS.png'/> similar to those seen in multiple sclerosis patients.](images/app.statdx.com_image_thumbnail_4161f150-8dc2-4c83-94b9-4ee9d01c70f7_size_168_quality_85_efb486ac_20251018T095234Z.jpg)
*Sagittal FLAIR MR of the brain in a CIDP patient shows a typical paraventricular demyelinating lesion <img src='/img/arrows/WS.png'/> similar to those seen in multiple sclerosis patients.*
![Sagittal T2WI MR depicts enlarged lumbar nerve roots extending into extraforaminal ventral primary rami <img src='/img/arrows/WS.png'/>.](images/app.statdx.com_image_thumbnail_4683fb7b-747f-4882-8f72-0a9b82b28723_annotated_true_size_900_quality_90_af319ef1_20251018T122453Z.jpg)
*Sagittal T2WI MR depicts enlarged lumbar nerve roots extending into extraforaminal ventral primary rami <img src='/img/arrows/WS.png'/>.*
![Sagittal T2WI MR depicts enlarged lumbar nerve roots extending into extraforaminal ventral primary rami <img src='/img/arrows/WS.png'/>.](images/app.statdx.com_image_thumbnail_4683fb7b-747f-4882-8f72-0a9b82b28723_size_168_quality_85_b2a08acd_20251018T095234Z.jpg)
*Sagittal T2WI MR depicts enlarged lumbar nerve roots extending into extraforaminal ventral primary rami <img src='/img/arrows/WS.png'/>.*