Use of intravenous gamma globulins in neuroimmunologic diseases

Intravenous gamma globulin (IVIg) is used in the treatment of immunologic d iseases that affect the entire neuroaxis, including the brain, spinal cord, peripheral nerves, muscles, and neuromuscular junction. The panel reviewed the available literature on the use of IVIg in order to evaluate the effic acy of this therapy in neuroimmunologic diseases. In prospective, rigorousl y controlled, double-blinded clinical trials, IVIg was found to have proven efficacy in the Guillain-Barre syndrome, chronic inflammatory demyelinatin g polyneuropathy, multifocal motor neuropathy, dermatomyositis, and Lambert -Eaton myasthenic syndrome. It was found to be probably effective in myasth enia gravis and polymyositis, and possibly effective in several other neuro immunologic diseases. Further studies are needed to evaluate the use of IVI g for neuroimmunologic diseases in which its efficacy is suspected but not proven and to elucidate its mechanisms of action.