title: Office immunotherapy in chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy.
abstract: Intravenous immunoglobulin [IVIg], plasma exchange [PE], and corticosteroids are efficacious treatment in chronic inflammatory demyelinating polyneuropathy [CIDP]. IVIg is effective in multifocal motor neuropathy [MMN]. NIS, NIS-weakness, sum scores of raw amplitudes of motor fiber (CMAPs) amplitudes, and Dyck/Rankin score provided reliable measures to detect and scale abnormality and reflect change; they are therefore ideal for office management of response-based immunotherapy (R-IRx) of CIDP. Using efficacious R-IRx, a large early and late therapeutic response (≥ one-fourth were in remission or had recovered) was demonstrated in CIDP. In MMN only an early improvement with late non-significant worsening was observed. The difference in immunotherapy response supports a fundamental difference between CIDP (immune attack on Schwann cells and myelin) and MMN (attack on nodes of Ranvier and axons).
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Dyck
authors.affiliation: Menzies Research Institute, Tasmania, Australia.
authors.forename: Bruce V
authors.initials: BV
authors.lastname: Taylor
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
authors.forename: Jenny L
authors.initials: JL
authors.lastname: Davies
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
authors.forename: Michelle L
authors.initials: ML
authors.lastname: Mauermann
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Litchy
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Klein
authors.affiliation: Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
authors.forename: P James B
authors.initials: PJ
authors.lastname: Dyck
mesh_terms: D000200:Action Potentials; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D004576:Electromyography; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D009431:Neural Conduction / Q000502:physiology; D009468:Neuromuscular Diseases / Q000276:immunology / Q000503:physiopathology / Q000628:therapy*; D010951:Plasma Exchange / Q000379:methods; D020277:Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / Q000276:immunology* / Q000503:physiopathology / Q000628:therapy*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D016756:Immunoglobulins, Intravenous
keywords: CIDP; MMN; immune therapy; neurophysiologic tests; signs