INFLAMMATORY NEUROPATHIES - PATHOGENESIS AND THE ROLE OF INTRAVENOUS IMMUNE GLOBULIN

The inflammatory neuropathies may be subdivided into an acute form, Gu illain-Barre syndrome, and a chronic form referred to as chronic infla mmatory demyelinating polyneuropathy. More recently a chronic, asymmet rical pure motor neuropathy with multifocal conduction blocks has been described. All three neuropathies are considered to be immune-mediate d. Their response to therapy is discussed, with special emphasis on hi gh-dose intravenous immune globulin. For Guillain-Barre syndrome the e fficacy of intravenous immune globulin has been proven in a randomized clinical trial. In chronic inflammatory demyelinating polyneuropathy a response rate of over 60% in newly diagnosed patients is suggested. Clinical prognostic criteria, however, seem to be very important to pr edict the effect of intravenous immune globulin. In multifocal motor n europathy intravenous immune globulin is at present the only alternati ve to cyclophosphamide.