ABSTRACT Introduction/Aims The distinct ultrasonographic and electrophysiological features separating typical chronic inflammatory demyelinating polyneuropathy (CIDP) from its motor‐predominant and pure motor variants remain poorly defined. We aimed to characterize the ultrasonographic, electrophysiological, and clinical features of these CIDP subtypes within a Chinese cohort. Methods Between March 2015 and January 2025, we prospectively enrolled consecutive patients meeting the 2021 European Academy of Neurology/Peripheral Nerve Society (EAN/PNS) diagnostic criteria for CIDP. All participants underwent standardized nerve ultrasound and nerve conduction studies (NCS). Results A total of 206 CIDP patients were recruited, including 145 with typical CIDP, 10 with motor‐predominant CIDP, and 8 with motor CIDP. Significant nerve enlargement was present in 34 (23.4%) of typical, one (10%) of motor‐predominant, and none of motor CIDP patients. Cross‐sectional areas (CSAs) at most upper limb nerve sites were significantly larger in motor‐predominant than in motor CIDP. Electrophysiologically, motor nerve conduction velocities (MCVs) of upper limb nerves were slower in motor‐predominant CIDP than in motor CIDP, and were also slower in distal segments in typical CIDP compared to motor‐predominant CIDP. Corticosteroid responsiveness demonstrated a clear declining trend across the subtypes: 93.8% (106/113) in typical, 85.7% (6/7) in motor‐predominant, and 50% (3/6) in motor CIDP. Discussion Our findings support the concept of a disease spectrum from typical to motor CIDP, characterized by progressively decreasing nerve CSA enlargement on ultrasound, less prominent demyelinating features on NCS, and a diminished therapeutic response to corticosteroids.
Niu et al. (Tue,) studied this question.