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Recommendations for the Diagnosis and Treatment of Chronic Inflammatory Demyelinating Polyneuropathy

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Recommendations for the Diagnosis and Treatment of Chronic Inflammatory Demyelinating Polyneuropathy CONACyT Vol. 18, núm. 6 (noviembre-diciembre de 2017) Rev Mex Neuroci ahora en Revista Mexicana de Neurociencia Publicación oficial de la Academia Mexicana de Neurología A.C. Revista Mexicana de Neurociencia; 18,6 (2017):1-103 Mexicana Revista Órgano Oficial de Difusión de la AMN Academia Mexicana de www.revmexneuroci.com / ISSN 1665-5044 Neurología, A.C. Editorial committee 2017 Chief editor: Dr. en C. Ildefonso Rodríguez Leyva [email protected] Co-editors: M.C. Carolina León Jimenez Dr. en C. Antonio Arauz Góngora [email protected] Founding editor: Dra. Lilia Núñez Orozco Emeritus editor: Dr. en C. Carlos Cantú Brito National editorial comitee Dr. Sergio de Jesús Aguilar Castillo Dr. Rubén Haro Silva Dra. Mayela Rodríguez Violante Dr. Marco Antonio Alegría Loyola Dr. Juan Calixto Hernández Aguilar Dr. Leopoldo Rivera Castaño Dra. Alma Yolanda Alvarado Dr. Héctor Gerardo Hernández Dr. Ulises Rodríguez Ortiz Gutierrez Rodríguez Dr. Francisco Rogel Ortiz Dr. Carlos Gabriel Ascanio Rodríguez Dr. Jesús Higuera Calleja Dr. Luis Ángel Ruano Calderón Dra. Catherine Boll Woehrlen Dr. Javier Jaramillo de la Torre Dra. Angélica Ruiz-Franco Dr. Antonio Bravo Oro Dr. Humberto Juárez Jiménez Dr. José Luis Ruiz-Sandoval Dr. Jorge Burgos Centeno Dr. Rubén Martínez Hernández Dr. José Manuel Sandoval Rivera Dra. Graciela Cárdenas Hernández Dra. Iris E. Martínez Juárez Dr. Daniel San Juan Dr. Paul Carrillo Mora Dra. Adriana Martínez Mayorga Dr. Horacio Sentíes Madrid Dra. Teresa Corona Vázquez Dr. Francisco Mena-Barranco Dra. Mónica Sierra del Rio Dra. Beatriz Chavez Dra. Roxana Millán Cepeda Dra. Ana Luisa Sosa Ortiz Dr. Bruno Estañol Vidal Dra. Rebeca Millán Guerrero Dr. José Luis Soto-Hernández Dra. Agnes Fleury Dr. Alberto Mimenza Alvarado Dr. Gersain Trujillo Alonso Dr. José Flores Rivera Dra. Leticia Munive Baez Dr. Steven Vargas Cañas Dra. Silvia García Dr. Luis Manuel Murillo Bonilla Dr. Rubén Darío Vargas García Dr. Fernando Góngora Rivera Dr. Alfredo Ponce de León Dra. Karina Vélez Jiménez Dra. Margarita González Cruz Dr. Guillermo Punzo Bravo Dr. Marco Zenteno Castellanos Dra. Alejandra González-Duarte Dra. Sandra Quiñones Aguilar Dr. Oscar González-Vargas Dra. María Teresa Reyes International editorial comitee Dr. Anthony Amato Dr. José Obeso Dr. José Biller Dr. Julio Pascual Dr. Andre Kanner Dr. Marc Patterson Dra. Farrah Mateen Dr. Eduardo Tolosa Dr. José Merino Dr. Samuel Wiebe Statistical Advisor Héctor Gerardo Hernández Rodríguez Style corrector Maestro Alejandro García Translator Rebeca Barroso Design Design Cortex Contenidos Contents GUÍAS DE PRÁCTICA CLÍNICA CLINICAL PRACTICE GUIDELINES • Recomendaciones sobre el diagnóstico • Recommendations on the diagnosis y tratamiento de la polineuropatía and treatment of chronic inflammatory desmielinizante inflamatoria crónica demyelinating polyneuropathy CONTRIBUCIONES ORIGINALES ORIGINAL CONTRIBUTIONS • Quejas subjetivas de memoria en población • Memory subjective complaints in geriatric geriátrica y sus factores asociados: estudio population and its related factors: a pilot study piloto en población mexicana in Mexican population • Funciones ejecutivas y conducta de • Executive functions and behavior of estudiantes secundarios ecuatorianos ecuadorian high school students • Desarrollo y salud en el diagnóstico • Development and health in the diagnosis in en trastorno por déficit de atención / attention-deficit / hyperactivity disorde hiperactividad REVIEWS • Falta título REVISIONES • Basal Ganglia and Behavior • Cefaleas por esfuerzo • Infectios of the Central Nervous System, part • Ganglios Basales y Conducta 2: neuroinfections in patients with Infection by • Infecciones del Sistema Nervioso Central, Human Immunodeficiency Virus parte 2: neuroinfecciones en pacientes con Infección por Virus de Inmunodeficiencia Humana CASE REPORTS • Marchiafava-Bignami: case report REPORTES DE CASO • Marchiafava bignami: reporte de un caso y EDITORIAL revisión de la literatura • Editorial Letter by Ildefonso Rodríguez Leyva EDITORIAL • Carta Editorial por Ildefonso Rodríguez Leyva 2 Systemic review Clinical practice guide Management of chronic inflammatory demyelinating polyneuropathy Clinical practice guide Edwin Steven Vargas-Cañas,1 Recommendations for the diagnosis Erwin Chiquete,2 Luis A. and treatment of chronic inflammatory Ruano-Calderón,3 Elizabeth León-Manríquez,1 Mónica demyelinating polyneuropathy Edith Salmerón-Mercado,1 Noel Isaías Plascencia-Álvarez,4 Recomendaciones sobre el diagnóstico y tratamiento de la Gabriela Madrigal-Salas,2 polineuropatía desmielinizante inflamatoria crónica David Gilberto Zúñiga-García,1 Humberto Juárez-Jiménez,5 Abstract Raúl Carrera-Pineda6 Chronic inflammatory demyelinating 1 Neuromuscular Diseases Clinic, Introduction. National Institute of Neurology polyneuropathy (or polyradiculoneuropathy, CIDP) is an uncommon and Neurosurgery “Manuel Velasco entity of very heterogeneous clinical behavior, but susceptible to Suárez,” Mexico City, Mexico. treatment. Several proposals on electrophysiological diagnostic 2Neuromuscular Diseases Clinic, criteria exist as well as numerous studies on the response to Department of Neurology and immunomodulatory treatments. The general consensus about its Psychiatry, National Institute of diagnosis and management, however, has not been reached in Mexico Medical Science and Nutrition through its major health institutions. “Salvador Zubiran,” Mexico City, Mexico. To develop a guideline on definition, diagnosis and 3Department of Neurology, Durango Objective. General Hospital, Durango, Mexico. treatment of the CIDP by using the best existing scientific evidence 4Department of Neurology, ISSSTE and when not available, the consensus of experts. National Medical Center “20 de Noviembre,” Mexico City, Mexico . Methods. A group of neurologists of Mexican institutions pertaining 5Department of Neurology, General to the Study Group of Neuromuscular Diseases of the Mexican Hospital “Doctor Gaudencio González Academy of Neurology carried out a MEDLINE and Cochrane Garza” at the IMSS National Medical systematic reviews search, selecting the best available evidence and Center “La Raza,” Mexico City, Mexico. qualifying the recommendations according to the GRADE 6 (Grading Department of Neurology, IMSS of Recommendations Assessment, Development and Evaluation) system. National Medical Center “Siglo XXI,” The recommendations are organized into short statements that are Mexico City, Mexico. supported by a brief dissertation on the scientific evidence of which the statements derived. Recommendations. This panel recommends testing and diagnostic criteria proposed by the EFNS/PNS (European Federation of Neurological Societies / Peripheral Nerve Society) that are described in the present document. For treatment aspects, this panel recommends intravenous immunoglobulin or steroids as first line treatment for the classical sensorimotor forms of CIDP, immunoglobulin exclusively for pure motor forms and plasma exchange in case of treatment failure Revista Mexicana de Neurociencia November-December, 2017; 18(6):1-18 Systemic review Clinical practice guide 3 Management of chronic inflammatory demyelinating polyneuropathy or incomplete response to immunoglobulin or steroids. In case of inappropriate response or required high doses or long periods of Keywords first-line drugs, immunomodulatory adjuvant therapy should be Clinical practice guideline, considered alone or in combination. chronic inflammatory demyelinating polyradiculoneuropathy, definition, diagnosis, management, treatment. Resumen Introducción. La polineuropatía (o también Evaluation). Las recomendaciones se organizan en polirradiculoneuropatía) desmielinizante enunciados breves que son sustentados por una inflamatoria crónica (PDIC) es una entidad breve disertación sobre la evidencia científica de la infrecuente, de comportamiento clínico muy que derivaron. heterogéneo, pero susceptible de tratamiento. Existen varias propuestas sobre los criterios de Recomendaciones. Este panel recomienda diagnóstico electrofisiológico, así como numerosos utilizar las pruebas y criterios diagnósticos estudios sobre la respuesta a tratamientos propuestos por la EFNS/PNS (European Federation inmunomoduladores. El consenso general sobre of Neurological Societies/ Peripheral Nerve Society), su diagnóstico y manejo, sin embargo, no se ha mismos que son expuestos en este documento. El alcanzado en México a través de sus principales panel recomienda la inmunoglobulina humana o instituciones sanitarias. esteroides como primera línea de tratamiento para las formas sensitivo-motoras clásicas de la PIDC, Objetivo. Elaborar una guía sobre definición, exclusivamente inmunoglobulina para la PDIC diagnóstico y tratamiento de la PDIC utilizando la motora pura y en caso de falla a inmunoglobulina mejor evidencia científica existente y cuando no o esteroide debe ser considerado el recambio esté disponible, el consenso de expertos. plasmático. Si la respuesta es inapropiada o se requieren dosis altas o largos periodos con los medicamentos de primera línea, debe ser Métodos. Un grupo de neurólogos de considerada la terapia coadyuvante sola o instituciones mexicanas y pertenecientes al grupo combinada con inmunomoduladores. de estudio de Enfermedades Neuromusculares de la Academia Mexicana de Neurología realizó una búsqueda en MEDLINE y revisiones sistemáticas Cochrane, seleccionando la mejor evidencia Palabras clave disponible clasificando la recomendación Definición, diagnóstico, guía de práctica clínica,
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