multifocal motor conductive block neuropathy

  For the last 20+ years my father has suffered from a gradual loss of motor skills.  As a result of this he has been home bound for the last 10 years and now barely has the ability to walk (even with assistance from a walker) from one room to the other.  The diagnosis of his disease has changed several times over the years.  (I have gotten the impression that this happened because he would not have lived as long as he has so far had the previous diagnoses been correct.)
  He recently went to see his neurologist.  Here is a copy of the letter the neurologist wrote to my father's primary care giver:
  "Dear Dr. (name withheld):
  Follow-up visit on this patient who has multifocal motor conductive block neuropathy.  Patient has quadriparesis with the lower extremities more affected.  Patient still has about Grade 2/5 weakness, they are quite spastic.  Patient has been in a wheelchair and becasue of him having physical therapy and occupational therapy this has really helped him.  There is still a lot of motion left.  I believe that if we stop the home health care (physical therapy and occupational therapy) this patient will go downhill.  Right now he is at a plateau and what is maintaining him at this plateau is all these therapies.  He has absent deep tendon reflexes.  He is to continue taking his Baclofen 10mg t.i.d.  I will see him here otherwise in about six months."
  Here is some additional information about my father:  He is presently 72 years old.  He also has emphasema and had portions of both lungs removed in the early 1980s.  He does get winded from physical exersion but doesn't require oxygen.
  Please answer the following questions:  
  What is "Grade 2/5 weakness"?  
  What is known about multifocal motor conductive block neuropathy and its causes?  
  What are the standard treatments for this disease?  
  What other treatments could be considered in my father's case?
  Thank you.
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Thanks for the questions. Muscle testing in this country is based on the Medical Research Council scale.
Grade 5 Normal power
Grade 4 Active movement against gravity and resistance
Grade 3 Active movement against gravity
Grade 2 Active movement with gravity removed
Grade 1 Flicker or trace contrcation
Grade 0 No contraction
My guess is that your father was first diagnosed with ALS. Motor neuropathy is thought to be a variant of ALS that affects mainly lower motor neurons. There has been an association with certain antidodies and an autoimmune hypothesis has arisen. Some patients respond to intravenous gamma globulin but it is currently in shortage in the US and very expensive. Other patients have been tried with various immunosuppressive medications. Patients usually have a long slow decline in function. There are various blood tests that can be done to help with the diagnosis, but usually a good EMG provides the best results
This information is provided for general medical education purposes. Please consult your doctor for diagnostic and treatment options.