Treatment of immune-mediated inflammatory neuropathies

Experimental models have suggested potential new treatments for human infla mmatory neuropathy, but current practice is largely based on empirical tria ls. Evidence from randomized trials supports the use of intravenous immunog lobulin in Guillain-Barre syndrome, chronic inflammatory demyelinating poly radiculoneuropathy (CIDP) and multifocal motor neuropathy with conduction b lock (MMNCB). In Guillain-Barre syndrome and CIDP intravenous immunoglobuli n is equivalent to but more convenient than plasma exchange. In MMNCB adequ ate comparative studies of intravenous immunoglobulin and plasma exchange h ave not been performed. Corticosteroid treatment is beneficial in CIDP, but not in Guillain-Barre syndrome and may worsen MMNCB. More randomized trial s and systematic reviews are needed to improve the evidence base for clinic al practice. Curr Opin Neurol 12:573-579. (C) 1999 Lippincott Williams & Wi lkins.