INTRAVENOUS IMMUNOGLOBULINS IN NEUROLOGY

Immunoglobulins, used at first empirically in the treatment of thrombo cytopenic purpura, occupy a prominent place not only in the treatment of antibody deficiencies, but also in that of antoimmune diseases. The ir indications in neurology are ever extending; they include myastheni a, chronic inflammatory polyneuropathies with or without monoclonal ga mmopathy, polymyositis, dermatomyositis and, more recently, disseminat ed sclerosis and Guillain-Barre syndrome. Even the therapeutic priorit y of plasmapheresis in this syndrome is disputed by some authors. Immu noglobulins are costly, but they are well tolerated and easy to use. T heir effectiveness must be confirmed by controlled, double-blind trial s. In neurology such trials are still rare, but those recently publish ed are devoid of methodological errors. Once the effectiveness of immu noglobulins is confirmed, their dosage must be established, and attemp ts should be made at a better understanding of their mechanisms of act ion.