Intravenous immunoglobulin (IVIg) with methylprednisolone pulse therapy for motor impairment of neuralgic amyotrophy: clinical observations in 10 cases.
BACKGROUND
Neuralgic amyotrophy (NA) is a distinct peripheral nervous system disorder characterized by attacks of acute neuropathic pain and rapid multifocal weakness and atrophy unilaterally in the upper limb. The current hypothesis is that the episodes are caused by an immune-mediated response to the brachial plexus, however, therapeutic strategies for NA have not been well established.


RESULTS
We retrospectively reviewed 15 case series of NA; 10 of the 15 patients received intravenous immunoglobulin (IVIg) with methylprednisolone pulse therapy (MPPT) and 9 of these 0 patients showed clinical improvement of motor impairment.


CONCLUSIONS
Our clinical observations do not contradict the possibility that IVIg with MPPT may be one of the potential therapeutics for NA, however the efficacy remains to be established. Further confirmatory trials are needed in patients with various clinical severities and phases of NA. Further basic research and confirmatory trials should be performed to survey the efficacy of such immunomodulation therapy for NA.
Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan.
Ko-suke
KS
Naito
Kazuhiro
K
Fukushima
Seiko
S
Suzuki
Motoi
M
Kuwahara
Hiroshi
H
Morita
Susumu
S
Kusunoki
Shu-ichi
S
Ikeda
D000328:Adult; D000368:Aged; D020968:Brachial Plexus Neuritis / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D055724:Electrophysiological Phenomena; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D056747:Immunomodulation; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D008875:Middle Aged; D009437:Neuralgia / Q000188:drug therapy / Q000628:therapy; D012189:Retrospective Studies; D016896:Treatment Outcome
D016756:Immunoglobulins, Intravenous; D008775:Methylprednisolone