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Multifocal motor neuropathy(MMN)is a progressive disorder producing asymmetrical weakness and muscle wasting.Case reports suggest that patients with MMN improve after cyclophosphamide therapy,but not after prednisone or plasmapheresis.Because MMN is likely to be immune mediated, we investigate the therapeutic response to human immune globulin(HIG)in an open,uncontrolled trial.Nine patients,ages 28 to 58 years had chronic, progressive,asymmetrical,predominantly distal,limb weak-ness for 5 to 18 years.Sensation was normal,reflexes were reduced asymmetrically.All had phsiological evidence of multifocal motor demyelination with partial motor conduction block,and 7 had elevated serum titers pf anti-GM1 1gM antibody. All patients were treated with HIG,i.6 to 2.4 gm/kg,given intravenously over 3-5 days.Strength improved in all patients 3-10 days after treatment, with improvement peaking at two weeks and lasting for an average of two months.The range of functional improvement varied from dramatic to mild. The degree of partial motor conduction was reduced,at least partially,in 7 of 8 patients.The serum anti-GM1 antibody titers did not change.Repeated courses of HIG resulted in similar improvements.We conclude that HIG may be effective therapy for patients wkth MMN. |
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gammaglobulin therapy,intravenous
neuropathy
neuropathy,motor
neuropathy,motor,multifocal
neuropathy,multifocal
neuropathy,peripheral,treatment
treatment of neurologic disorder
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