CLINICAL AND NEUROPHYSIOLOGICAL ASSESSMENT OF IMMUNOGLOBULIN THERAPY IN 5 PATIENTS WITH MULTIFOCAL MOTOR NEUROPATHY

High dose intravenous immunoglobulin (IVIg) is an effective treatment for demyelinating neuropathies. IVIg was given to five patients with m ultifocal motor neuropathy, a motor neuropathy showing a clinical synd rome of asymmetrical weakness and amyotrophy, electrophysiological evi dence of motor conduction block and, in many cases, high titres of ser um anti-GM1 antibodies. Muscle strength was evaluated by a conventiona l score before and after each IVIg course. In all patients there was r elevant improvement on muscle strength after each immunoglobulin cours e, but in most cases the clinical benefits partially declined after th ree to eight weeks. At the eight month follow up, however, the pretrea tment examination showed a significant improvement compared with the i nitial evaluation. The effects of each IVIg course were still present after a number of courses. Electrophysiological study revealed a decre ase in conduction block in one or more nerves in all patients. However , conduction block was unchanged or increased in other sites. IVIg tre atment did not affect anti-GM1 antibody titres.