THE CLINICAL AND DIAGNOSTIC ROLE OF ANTI-GM(1) ANTIBODY TESTING

There is increasing evidence that multifocal motor neuropathy (MMN) an d some lower motor neuron (LMN) syndromes are immune-mediated and trea table. The frequent occurrence of high titers of anti-GM(1) antibodies in these motor neuropathies raised hopes that serum testing would pro vide useful diagnostic information. Unfortunately, in routine practice , simple quantification of IgM binding to GM(1) ganglioside has proved to be a test with poor sensitivity and specificity. We have found tha t much greater sensitivity and specificity for MMN and LMN syndromes c an be obtained by determining serum antibody binding to panels of anti gens, such as GM1, histone H3, and NP-9. These results suggest that co mbined measurement of serum antibody binding to GM, and other antigens can provide tests that are useful in the diagnosis and management of motor neuropathy syndromes. (C) 1994 John Wiley and Sons, Inc.