If you have multiple sclerosis (MS), you may have heard of another autoimmune neurological condition called chronic inflammatory demyelinating polyneuropathy (CIDP). But what is CIDP?

While both are autoimmune diseases that affect the nervous system, they damage different parts of it. CIDP affects the peripheral nerves, which are outside the brain and spinal cord. MS affects the central nervous system, which includes the brain and spinal cord.

Keep reading to learn more about CIDP and how it differs from MS.

How Is CIDP Different From MS?

Both MS and CIDP occur when your immune system attacks the myelin sheaths around your nerves. In MS, however, this damage happens to cells in your brain and spinal cord. With CIDP, the autoimmune attack damages the peripheral nerves — the nerves throughout your body outside the brain and spinal cord.

Symptoms of CIDP vs. MS

While some symptoms of MS and CIDP can look similar, there are key differences that help tell the diseases apart. Both MS and CIDP can cause dizziness, balance and coordination problems, decreased sensation, numbness, tingling, weakness, and loss of mobility.

Muscle Weakness

Muscle weakness is a key symptom of both CIDP and MS. However, with MS, muscle weakness usually affects one side of your face or body, or below your waist.

With CIDP, weakness usually affects both sides of your body equally and usually impacts the hips, thighs, shoulders, upper arms, hands, and feet. Tremors are also possible in both diseases.

Additionally, reflexes are brisk in MS but decreased or absent in CIDP.

Abnormal Nerve Sensation

Both MS and CIDP commonly cause numbness, tingling, and nerve pain. These are core symptoms for CIDP, but with MS, they don’t always happen.

Many MyMSTeam members have mentioned CIDP as a condition that they were either diagnosed with incorrectly or that they should have been diagnosed with and weren’t.

In MS, these sensations may affect only one side of your face or body, whereas in CIDP, they’re more likely to affect both sides the same. Prickling in your fingers and toes is more characteristic of CIDP than it is of MS.

One MyMSTeam member described the tingling sensation this way: “I swatted ants off my legs all day that weren’t there. This is a new symptom for me.”

Fatigue

Fatigue is common in CIDP. Fatigue is also very common in MS, although the exact percentage can differ depending on how fatigue is measured. In people with MS, fatigue may worsen as the day goes on and in warm or humid weather.

Balance Problems

MS and CIDP can both cause problems with balance and coordination. These symptoms could be written off as simple clumsiness, but it’s important to look into them. If you are stumbling, falling, or dropping things more than usual, it’s a good idea to talk to a healthcare professional.

Other MS Symptoms

Certain symptoms that are typical of MS are not common in CIDP. These include:

• Mood changes
• Speech difficulties
• Problems with thinking, concentrating, and memory
• Problems with bladder control
• Vision loss or vision changes

Testing and Diagnosis for CIDP and MS

Neither CIDP nor MS can be diagnosed with a single test. For both conditions, it’s often necessary to do a variety of tests to rule out other diseases that might look similar.

The tests used to diagnose CIDP may be different from many of the tests used to diagnose MS.

In addition to a complete physical and neurological exam, the following tests may be used.

CIDP Diagnostic Tests

• Electromyography and nerve conduction tests
• Lumbar puncture (spinal tap)
• MRI to look at nerve roots (often in the neck and/or lower back area)
• Nerve ultrasound (in some clinics) to look for signs of nerve swelling

MS Diagnostic Tests

• Blood tests and urine tests
• MRI of your brain and spinal cord
• Optical coherence tomography test
• Lumbar puncture
• Evoked potential test

Diagnosis Difficulties With CIDP and MS

MS and CIDP both can be difficult to diagnose. Studies point to a lot of overdiagnosis of CIDP, and many people with MS describe a long road to finally receiving a correct diagnosis.

MS Diagnosis Challenges

Although the treatment and diagnosis of MS have advanced a lot in the past decade, it’s still fairly common to experience misdiagnosis. One study found that up to 30 percent of people who were initially told they had MS were ultimately diagnosed with something else.

More than 50 percent of these people had been living with the misdiagnosis for over three years, and 70 percent had already started MS disease-modifying therapies, which can be expensive and even unhealthy if you don’t actually need them.

“My neurologist has had me going in all different directions now for two years. I have MS, then I don't have MS, then I have fibromyalgia, then I don't have fibromyalgia. First, I had CIDP; now I don't have CIDP. I am so confused!” — A MyMSTeam member

Because no single test can confirm MS, getting a diagnosis can take a long time and feel overwhelming. Delays may happen when providers aren’t familiar with MS, when a person has other conditions with similar symptoms, or when specialist appointments take a long time to schedule.

Before 2001, it was common for an MS diagnosis to take four years or more. Now, the average is about a year, but many MyMSTeam members still report struggling to be properly diagnosed.

Many members have mentioned CIDP as a condition that they were either diagnosed with incorrectly or that they should have been diagnosed with and weren’t.

CIDP Diagnosis Challenges

CIDP can be hard to diagnose for some of the same reasons as MS. There’s no clear single test that says whether you have it. CIDP can also affect people in many different ways.

One 2015 review of all previously diagnosed CIDP cases at a large hospital found that nearly half of them (47 percent) did not actually have CIDP. If you are unsure about your care or feel like you aren’t being heard about your symptoms, it may be a good idea to seek another opinion.

MyMSTeam Members Weigh In

“My neurologist has had me going in all different directions now for two years. I have MS, then I don’t have MS, then I have fibromyalgia, then I don’t have fibromyalgia. First, I had CIDP; now I don’t have CIDP. I am so confused!” said one member.

“I was misdiagnosed for at least 20 years before I was finally diagnosed with MS,” said another.

“I have CIDP as well as MS. Some of the time, I can’t even tell what each symptom is caused by because there are so many things mixed up with each other. It drives me bananas,” said one member.

“I have both RA and OA as well as lupus, Sjögren’s, and CIDP in addition to MS. I joke that I am trying to set the Guinness world record for old ladies with autoimmune diseases,” another member said.

Treatment for CIDP vs. MS

CIDP and MS are treated in different ways.

Common first treatments for CIDP include intravenous immunoglobulin (IVIG) and corticosteroids. Plasma exchange (plasmapheresis) may be used if those treatments don’t work well enough or aren’t a good fit. Some people also use subcutaneous immunoglobulin as a maintenance treatment after IVIG helps improve their symptoms.

Treatment options for MS include disease-modifying therapies, which slow MS progression, reduce relapses, and prevent new lesions, as well as other treatments that manage symptoms.

Symptom-management treatments can include:

• Mental health care
• Glasses or medication to help with vision
• Deep brain stimulation to treat tremors
• Anti-seizure or pain relief medications
• Corticosteroids for severe attacks
• Assistive and mobility therapies and devices

Join the Conversation

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

Do you have CIDP? Were you misdiagnosed with CIDP or MS before getting an accurate diagnosis? Let others know in the comments below.