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Muscle Nerve. 2015 Oct;52(4):488-97. doi: 10.1002/mus.24707. Epub 2015 Aug 13.

Office immunotherapy in chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy.

Author information

1
Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
2
Menzies Research Institute, Tasmania, Australia.

Abstract

Intravenous immunoglobulin [IVIg], plasma exchange [PE], and corticosteroids are efficacious treatment in chronic inflammatory demyelinating polyneuropathy [CIDP]. IVIg is effective in multifocal motor neuropathy [MMN]. NIS, NIS-weakness, sum scores of raw amplitudes of motor fiber (CMAPs) amplitudes, and Dyck/Rankin score provided reliable measures to detect and scale abnormality and reflect change; they are therefore ideal for office management of response-based immunotherapy (R-IRx) of CIDP. Using efficacious R-IRx, a large early and late therapeutic response (≥ one-fourth were in remission or had recovered) was demonstrated in CIDP. In MMN only an early improvement with late non-significant worsening was observed. The difference in immunotherapy response supports a fundamental difference between CIDP (immune attack on Schwann cells and myelin) and MMN (attack on nodes of Ranvier and axons).

KEYWORDS:

CIDP; MMN; immune therapy; neurophysiologic tests; signs

PMID:
25976871
PMCID:
PMC4621010
DOI:
10.1002/mus.24707
[Indexed for MEDLINE]
Free PMC Article

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