Abstract
High dose intravenous immunoglobulin (IVIg) is an effective treatment for demyelinating neuropathies. IVIg was given to five patients with multifocal motor neuropathy, a motor neuropathy showing a clinical syndrome of asymmetrical weakness and amyotrophy, electrophysiological evidence of motor conduction block and, in many cases, high titres of serum anti-GM1 antibodies. Muscle strength was evaluated by a conventional score before and after each IVIg course. In all patients there was relevant improvement on muscle strength after each immunoglobulin course, but in most cases the clinical benefits partially declined after three to eight weeks. At the eight month follow up, however, the pretreatment examination showed a significant improvement compared with the initial evaluation. The effects of each IVIg course were still present after a number of courses. Electrophysiological study revealed a decrease in conduction block in one or more nerves in all patients. However, conduction block was unchanged or increased in other sites. IVIg treatment did not affect anti-GM1 antibody titres.
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- Chaudhry V., Corse A. M., Cornblath D. R., Kuncl R. W., Drachman D. B., Freimer M. L., Miller R. G., Griffin J. W. Multifocal motor neuropathy: response to human immune globulin. Ann Neurol. 1993 Mar;33(3):237–242. doi: 10.1002/ana.410330303. [DOI] [PubMed] [Google Scholar]
- Feldman E. L., Bromberg M. B., Albers J. W., Pestronk A. Immunosuppressive treatment in multifocal motor neuropathy. Ann Neurol. 1991 Sep;30(3):397–401. doi: 10.1002/ana.410300312. [DOI] [PubMed] [Google Scholar]
- Kaji R., Oka N., Tsuji T., Mezaki T., Nishio T., Akiguchi I., Kimura J. Pathological findings at the site of conduction block in multifocal motor neuropathy. Ann Neurol. 1993 Feb;33(2):152–158. doi: 10.1002/ana.410330204. [DOI] [PubMed] [Google Scholar]
- Kaji R., Shibasaki H., Kimura J. Multifocal demyelinating motor neuropathy: cranial nerve involvement and immunoglobulin therapy. Neurology. 1992 Mar;42(3 Pt 1):506–509. doi: 10.1212/wnl.42.3.506. [DOI] [PubMed] [Google Scholar]
- Lange D. J., Trojaborg W., Latov N., Hays A. P., Younger D. S., Uncini A., Blake D. M., Hirano M., Burns S. M., Lovelace R. E. Multifocal motor neuropathy with conduction block: is it a distinct clinical entity? Neurology. 1992 Mar;42(3 Pt 1):497–505. doi: 10.1212/wnl.42.3.497. [DOI] [PubMed] [Google Scholar]
- Nobile-Orazio E., Meucci N., Barbieri S., Carpo M., Scarlato G. High-dose intravenous immunoglobulin therapy in multifocal motor neuropathy. Neurology. 1993 Mar;43(3 Pt 1):537–544. doi: 10.1212/wnl.43.3_part_1.537. [DOI] [PubMed] [Google Scholar]
- Parry G. J., Sumner A. J. Multifocal motor neuropathy. Neurol Clin. 1992 Aug;10(3):671–684. [PubMed] [Google Scholar]
- Pestronk A. Invited review: motor neuropathies, motor neuron disorders, and antiglycolipid antibodies. Muscle Nerve. 1991 Oct;14(10):927–936. doi: 10.1002/mus.880141002. [DOI] [PubMed] [Google Scholar]
- Sadiq S. A., Thomas F. P., Kilidireas K., Protopsaltis S., Hays A. P., Lee K. W., Romas S. N., Kumar N., van den Berg L., Santoro M. The spectrum of neurologic disease associated with anti-GM1 antibodies. Neurology. 1990 Jul;40(7):1067–1072. doi: 10.1212/wnl.40.7.1067. [DOI] [PubMed] [Google Scholar]
- Vermeulen M., van Doorn P. A., Brand A., Strengers P. F., Jennekens F. G., Busch H. F. Intravenous immunoglobulin treatment in patients with chronic inflammatory demyelinating polyneuropathy: a double blind, placebo controlled study. J Neurol Neurosurg Psychiatry. 1993 Jan;56(1):36–39. doi: 10.1136/jnnp.56.1.36. [DOI] [PMC free article] [PubMed] [Google Scholar]
- van der Meché F. G., Schmitz P. I. A randomized trial comparing intravenous immune globulin and plasma exchange in Guillain-Barré syndrome. Dutch Guillain-Barré Study Group. N Engl J Med. 1992 Apr 23;326(17):1123–1129. doi: 10.1056/NEJM199204233261705. [DOI] [PubMed] [Google Scholar]