Chronic inflammatory demyelinating polyneuropathy (CIDP) is a defined clini
cal entity with a chronic progressive or chronic relapsing course, lasting
months to years. It causes variable but often severe chronic disability. CI
DP is considered an autoimmune disorder caused by both cellular and humoral
immune processes. Various immunomodulatory therapies, i.e., Mg, therapeuti
c plasma exchange (PE), and prednisone, are of proven benefit. Comparative
studies indicate that Mg and PE confer equal short-term benefit. Efficacy o
f Mg is maintained; regularly timed pulse treatments may stabilize relapsin
g CIDP. The combination of Mg and prednisone may be advantageous in long-te
rm management. Despite the high cost, Mg is considered the preferred first
treatment. The safety profile is similar to that reported far other conditi
ons; close monitoring during the infusion is recommended. The precise mecha
nisms of Mg action in CIDP are not known. Anti-idiotypic neutralization of
autoantibodies, binding of complement, and blockade of macrophages may prev
ent the ongoing inflammatory demyelination.