Three patients with chronic inflammatory demyelinating polyneuropathy (CIDP) with acute onset
initially diagnosed as Guillain-Barre syndrome were presented. Case 1 had profound weakness over
8 weeks but followed a monophasic recovery course and was almost full recovery at 6 months and
remained well one year later, whereas Case 2 recovered with two relapses at 4 and 5 months followed
by full remission at 6 months. Case 3 had almost monthly relapses over 2 years, requiring monthly
intravenous immunoglobulin and 4 courses of intravenous methylprednisolone. Despite frequent
relapses, clinical evidence of areflexia and neurophysiologic evidence of chronic neuropathy, Case
3 remained strong during remission. No causes were found except Case 2 may be due to reactivated
latent Epstein-Barr virus. Unlike those with subacute or indolent onset, CIDP with acute onset may
represent a very distinct variant with good outcome. We believe that acute onset CIDP variant and
Guillain-Barre syndrome most likely represent parts of a continuum, arbitrarily separated by their
time course. The supporting arguments are presented; diagnosis and management difficulties are
briefly discussed.