• Muscle & nerve · Oct 2015

    Review

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

    • Peter J Dyck, Bruce V Taylor, Jenny L Davies, Michelle L Mauermann, William J Litchy, Christopher J Klein, and P James B Dyck.
    • Department of Neurology, Mayo Clinic, 200 First Street SW, Rochester, Minnesota, 55905, USA.
    • Muscle Nerve. 2015 Oct 1; 52 (4): 488-97.

    AbstractIntravenous 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).© 2015 Wiley Periodicals, Inc.

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