What’s the Difference Between Chronic Inflammatory Demyelinating Polyneuropathy and Guillain-Barré Syndrome?

“Both conditions are caused by some sort of dysfunction of the immune system,” says Michal Vytopil, MD, PhD, vice chair of neurology at Beth Israel Lahey Health’s Lahey Hospital and Medical Center in Burlington, Massachusetts. “And the set of symptoms is often very similar — both can cause weakness, numbness, loss of reflexes, and coordination problems.”

People with either condition may notice trouble walking, tingling in the hands or feet, muscle pain, or fatigue. With GBS, symptoms usually worsen quickly over days or weeks and can sometimes affect breathing or cause sudden changes in heart rate or blood pressure. CIDP symptoms tend to develop more slowly in waves and are less likely to involve serious body systems.

• Electromyography (EMG) Thin needles are inserted to measure nerve health and activity.
• Nerve Conduction Studies Mild electrical signals measure how quickly your nerves send messages.
• Spinal Tap A sample of fluid from your lower spine is checked for elevated proteins and white blood cells.
• MRI (Magnetic Resonance Imaging) Images the nerves to detect inflammation
• Blood and Urine Tests Rule out other conditions that can affect nerves, such as diabetes, thyroid problems, and Lyme disease.

While the conditions are similar in their symptoms, diagnosis, and treatment, GBS and CIDP differ in their root cause, duration, and overall impact on your health.

Cause

Condition Onset and Duration

“Guillain-Barré syndrome is a monophasic condition,” explains Richard Lewis, MD, a professor of neurology at Cedars-Sinai in Los Angeles, which means that it is a single bout of illness that typically gets better and doesn’t return. On the other hand, “CIDP is an ongoing illness that requires ongoing treatment,” Dr. Lewis says.

Prognosis

One reason the conditions are often conflated is that there is a type of CIDP that can initially appear to be GBS — a disorder called acute onset CIDP, explains Lewis. “Patients with acute onset CIDP look like they could have Guillain-Barré syndrome, and it's not until eight weeks later that you realize that the disorder is ongoing,” says Lewis. “It's not necessarily a misdiagnosis — you simply can't diagnose CIDP at four weeks because you haven't had enough time.” What’s positive, says Lewis, is that the treatment you may have received for what was thought to be GBS is typically also effective for CIDP.

• Guillain-Barré syndrome and CIDP are rare autoimmune disorders in which the immune system attacks peripheral nerves, causing symptoms such as weakness, numbness, and coordination problems.
• A key difference is that GBS is a sudden, usually one-time illness that often follows an infection and typically improves over weeks to months, while CIDP is a chronic condition marked by ongoing or relapsing nerve damage that requires long-term management.
• Both conditions are diagnosed through clinical history, neurological exams, and tests such as nerve studies and spinal taps, and are commonly treated with IVIG or plasma exchange.