PURE MOTOR DEMYELINATING NEUROPATHY - DETERIORATION AFTER STEROID TREATMENT AND IMPROVEMENT WITH INTRAVENOUS IMMUNOGLOBULIN

Within one month of starting oral prednisolone treatment weakness unex pectedly increased in four patients aged 34 to 75 years with purely mo tor forms of acquired chronic demyelinating neuropathy. By contrast, s teroids produced the expected improvement in 11 other patients with sy mmetric sensorimotor chronic inflammatory demyelinating polyneuropathy . Two of the patients with purely motor demyelinating neuropathy were subsequently treated with high dose IVIg (0.4 g/kg/day for five days) with prompt improvements in strength measurements and motor nerve cond uction. Thus IVIg seems to be the treatment of choice and steroids sho uld be used with extreme caution, if at all, in patients with purely m otor forms of acquired demyelinating polyneuropathy.