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Neurology (Expert Forum)
add to immune-mediated question-MMN?
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add to immune-mediated question-MMN?
by Christine__0__0, Oct 16, 1998 12:00AM
Just wanted to also ask about whether you can tell me what Multifocal Motor Neuropathy is. I read that it is similar to ALS but not progressive and responds to IVG treatment. What is IVG treatment? Is it an immunosuppressant?
Doctor's Answer
by CCF Neuro MD MJD, Oct 16, 1998 12:00AM
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Multifocal Motor Neuropathy is a disease of the motor nerves that is presumed to have an immune cause. Since it is a disease of the motor nerves and doesn't involve the "upper moter neurons" (nerves controlling motor activity that travel from brain to spine), it can cause some features seen in ALS like weakness and muscle atrophy but not the spasticity or active reflexes. Iin fact the diagnosis of ALS is based upon evidence that both the upper moter neurons and the "lower motor neurons" (which travel from roots in the spine to the muscles) are affected. So, the features of Multifocal Motor Neuropathy can mimic SOME cases of ALS but generally is not confused clinically. The people affected are generally younger (generally less than 45 years of age) and men are affected more than females. Diagnosis is suggested by a certain pattern on EMG (the electrical study of nerves and muscles) and the presence of a certain type of antibodies. As I stated, most cases of ALS are not confused with multifocal motor neuropathy - so then why is it often mentioned as something to "rule out". Because unlike the untreatable ALS, many cases of Multifocal Motor Neuropathy respond to either Intravenous Immunoglobulin (or a chemotherapy drug Cyclophosphamide). Given the fact that this may be treatable, it should be evaluated for in any patient who has a suspicious picture (for example younger patients or patients without spasticity and brisk reflexes).
In response to your second question, Intravenous Immunoglobulin is just what it sounds like - it is antibodies that are given through an IV - these antibodies can often help diseases where the body's immune system is involved. Unfortunately, it is quite scarse currently and only readily available for some diseases.
Hope this was of help.
