Intravenous immunoglobulin treatment in multifocal motor neuropathy

Charles, N. Bernstein; Vial, Christophe; Moreau, Thibault; Benoit, P; Bierme, T.; Bady, B

doi:10.1016/0140-6736(92)93267-q

Cited by 35 publications

(14 citation statements)

References 4 publications

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“…We did not treat our MMN patients with corticosteroids, but the literature describes an extremely poor response, with less than 3% of reported patients responding. 4,10,16,18,20,22,26,29,32,34 In contrast, improvement occurred in 50% of our MADSAM neuropathy patients treated with prednisone.…”

Section: Discussioncontrasting

confidence: 53%

Multifocal acquired demyelinating sensory and motor neuropathy: The Lewis-Sumner syndrome

et al. 1999

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Section: Discussioncontrasting

confidence: 53%

Multifocal acquired demyelinating sensory and motor neuropathy: The Lewis-Sumner syndrome

et al. 1999

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“…ț Pure motor neuropathies respond excellently to IVIg, yet they are usually unresponsive or may deteriorate with steroids [10]. IvIg is clearly the preferred treatment in such patients [7,8,10,17,21]. The finding of a high frequency of conduction block in both PMDN and MMN, along with their distinctive treatment responsiveness, raises the possibility that IvIg is specifically effective in reversing conduction block.…”

Section: Discussion S Relationship To Previous Classificationsmentioning

confidence: 97%

Chronic dysimmune neuropathy

Busby

Donaghy

2003

Journal of Neurology

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The Chronic Dysimmune neuropathies (CDN) are a clinically heterogeneous group of polyneuropathies united by their presumed immune mediated aetiology. At present such neuropathies are classified as Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), Multifocal Motor Neuropathy (MMN) and the Neuropathies in association with serum Paraproteins (Paraproteinaemic Neuropathies). This classification fails to recognise other distinctive syndromes and is limited by heterogeneity within, and overlap between, subgroups. We have refined this clinical subclassification by a review of a consecutive series of 102 unselected patients with CDN referred to a single neurologist. We recognise 6 clinical subtypes of CDN: one sensory ataxic group; three motor-sensory subgroups (chronic motor sensory demyelinating neuropathy, subacute motor sensory demyelinating neuropathy and a multifocal motor sensory neuropathy); and two pure motor subgroups (symmetric pure motor demyelinating neuropathy and multifocal motor neuropathy). This subclassification allows distinct syndromes to be recognised and helps resolve problems of heterogeneity and overlap. Distinction between these subgroups is of immediate practical relevance to patient management. Although steroids are beneficial for most of the subgroups, this is not so for both of the pure motor syndromes which should be treated with intravenous immunoglobulin. Patients with chronic development of Motor Sensory Demyelinating Neuropathy respond less well to steroids than those with a subacute onset. An association was found between elderly patients with Subacute Motor Sensory Demyelinating Neuropathy and carcinomas. Within any clinical subgroup patients behave similarly regardless of the presence of associated paraproteins or nerve specific antibodies.

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“…9 The MVIC score was obtained for eight muscles and always included the most affected muscles in the upper and lower limbs during a maximal isometric contraction lasting 10 by the same examiner before drug treatment, with the patient in standard positions defined for each muscle tested. The eight muscle scores were summed to obtain a total MVIC score.…”

mentioning

confidence: 99%