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Recent studies reported the presence of anti-ganglioside antibodies in occasional patients with motor neuron disease.We found polyclonal serum IgM anti-GM antibodies and an anti-GM enzyme-linked immunosorbent assay (ELISA)in 9(19%)of 48 patients with motor neuron disease.A comparable frequency of IgM anti-GM antibodies was found in 4(10%)of 40 sera from patients with other neurological disease.Three(17%)of 18 sera from patients with motor neuron disease and 2(17%)of 12 sera from patients with other neurological diseases had anti-GM immunostaining as shown by thin layer chromatography immunoblot.One patient with a lower motor neuron variant of motor neuron disease or motor axonopathy without multifocal conduction block had a markedly elevated polyclonal IgM anti-GM ELISA titer(>1:64,000)with prominent immunostaining of GM,moderate immunostaining of GM,and weak and inconsistent immunostaining of GDlb by thin layer chromatography immunoblot.Treatment with prednisone resulted in clinical improvement despite increasing anti-GM1 antibody titers.These data indicate that patients with motor neuron disease have measurable levels of anti-ganglioside antibodies as frequently as patients with other neurological diseases.This contrasts with a small subgroup of patients with a lower motor neuron variant of motor neuron disease or motor axonopathy who have markedly elevated levels of serum anti-ganglioside antibodies and a clinical syndrome that is treatable with immunosuppression. |
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