title: Immunotherapy of multifocal motor neuropathy.
abstract: BACKGROUND
  Multifocal motor neuropathy (MMN) is an immune-mediated disease, which usually runs a chronic course. Current treatments are aiming at modulation of the immune response to maintain functional status. Although patients can remain stable with prolonged maintenance intravenous immunoglobuin (IVIg) treatment, most patients slowly deteriorate over many years despite increasing IVIg doses.
  
  
  METHODS
  The paper identifies studies since 1985 for patients with MMN. Randomised and non-randomized studies examining the effects of any therapeutic agent were selected, to give a full overview of the different treatments for MMN. The review provides a treatment algorithm together with our views on current treatments, ongoing trials and possible directions for further research.
  
  
  CONCLUSIONS
  IVIg remains the only proven treatment for MMN, although questions around dosages and duration of treatment remain. The presence of an effective therapy for MMN should not discourage but stimulate further research into alternative treatments as ongoing axonal damage results in increasing impairment in patients with MMN.
authors.affiliation: University of Amsterdam, Neurology, Academic Medical Center, PO Box 22700 Amsterdam, Netherlands. F.Eftimov@amc.uva.nl
authors.forename: Filip
authors.initials: F
authors.lastname: Eftimov
authors.forename: Ivo N
authors.initials: IN
authors.lastname: Van Schaik
mesh_terms: D000818:Animals; D001688:Biological Products / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D019317:Evidence-Based Medicine; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D007167:Immunotherapy / Q000379:methods*; D016472:Motor Neuron Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000276:immunology; D009046:Motor Neurons / Q000187:drug effects* / Q000276:immunology; D009431:Neural Conduction / Q000187:drug effects; D009460:Neurologic Examination; D018570:Risk Assessment; D016896:Treatment Outcome
chemical_list: D001688:Biological Products; D016756:Immunoglobulins, Intravenous