[Long-term maintenance therapy of multifocal motor neuropathy by weekly administration of human immunoglobulin].
High-dose intravenous immunoglobulin therapy for multifocal motor neuropathy (MMN) exhibits a beneficial, but temporary effect in most cases. We experienced a patient with MMN having a high titer of anti-GM1 ganglioside antibody. He was weekly administered human immunoglobulin, and his muscle strength was successfully improved and maintained at the improved level after high-dose human immunoglobulin infusion. The pattern of improvement and maintenance by weekly administration of human immunoglobulin was variable among the muscles; e.g. only a minimal improvement was observed in the most severely involved brachioradial muscles. Successive measurements with a hand-held dynamometer revealed in detail the changes in the strength of each muscle during treatment. Anti-GM1 ganglioside antibody titers did not significantly change during the treatment, but a slight improvement in motor conduction amplitudes and velocities was observed in mildly affected nerves. Our findings suggest that weekly administration of human immunoglobulin is a safe and effective therapy for MMN and that the anti-GM1 ganglioside antibody titer may not be a good indicator for this therapy.
Shiratori
M
M
Department of Neurology, Nagoya University, School of Medicine, Japan.
Saitou
K
K
Inukai
A
A
Aoki
S
S
Sobue
G
G
D000328:Adult; D001323:Autoantibodies / Q000097:blood; D016537:Gangliosidosis, GM1 / Q000276:immunology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D008297:Male; D016472:Motor Neuron Disease / Q000503:physiopathology / Q000628:therapy*; D009046:Motor Neurons / Q000502:physiology; D018482:Muscle, Skeletal / Q000503:physiopathology; D009431:Neural Conduction
D001323:Autoantibodies; D016756:Immunoglobulins, Intravenous