IMMUNOSUPPRESSIVE TREATMENT IN LOWER MOTOR-NEURON SYNDROME WITH AUTOANTIBODIES AGAINST GM1 GANGLIOSIDE

We report the results of immunosuppressive treatment with intravenous cyclophosphamide in 12 patients with lower motor neuron syndrome and e levated titers of serum autoantibodies to GM 1 ganglioside. All patien ts had lower motor neuron dysfunction including proximal or distal wea kness, fasciculation and muscle atrophy, but no upper motor neuron dys function such as hyperreflexia, spasticity or Babinski's sign. Electro physiological studies revealed no evidence of conduction block, but EM G findings of acute or chronic denervation in the limbs were present. Serum biochemistry and immunological studies were negative for M prote in. After a 6-month follow-up, despite a fall in antibody titer, there was no significant clinical improvement in any of the patients.