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We treated five consecutive patients with multifocal motor neuropathy(MMN) with high-dose intravenous immunoglobulin(IVIg).Four patients had increased levels of anti-asialo-GM1,IgM and two of anti-GM1 IgM as well; one patient had no reactivity.We treated them twice with 0.4 g/kg IVIg for 5 consecutive days at a 2-month interval,followed by maintenance infusions up to 6 to 12 months.All patients with high anti-asialo-GM1 had a consistent clinical improvement starting 3 to 10 days after the first IVIg course;in one patient,recovery was complete and persistent for 12 months without additional treatment,while in three patients,improvement only lasted 20 to 30 days.There was a similar improvement in these patients after the second course of IVIg which was maintained by periodic 2-day IVIg infusions.Clinical improvement in these patients was associated with a reduction of conduction block in most,but not all,motor nerves,while antibody titers were not consistently modified by treatment.There was no clinical or electrophysiologic improvement in the patient without antiglycolipid activity after 6 months of IVIg.IVIg may be a safe and effective therapy for MMN. |
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gammaglobulin therapy,intravenous
neuropathy
neuropathy,motor,multifocal
neuropathy,multifocal
neuropathy,peripheral,treatment
treatment of neurologic disorder
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