TY - JOUR
T1 - Multifocal motor neuropathy
AU - van Asseldonk, Jan-Thies H.
AU - Franssen, Hessel
AU - van den Berg-Vos, Renske M.
AU - Wokke, John H. J.
AU - van den Berg, Leonard H.
PY - 2005/5/1
Y1 - 2005/5/1
N2 - Multifocal motor neuropathy (MMN) is an immune-mediated disorder characterised by slowly progressive, asymmetrical weakness of limbs without sensory loss. The clinical presentation of MMN mimics that of lower-motor-neuron disease, but in nerve-conduction studies of patients with MMN motor-conduction block has been found. By contrast with chronic inflammatory demyelinating polyneuropathy, treatment with prednisolone and plasma exchange is generally ineffective in MMN and even associated with clinical worsening in some patients. Of the immunosuppressants, cyclophosphamide has been reported as effective but only anecdotally. Various open trials and four placebo-controlled trials have shown that treatment with high-dose intravenous immunoglobulin leads to improvement of muscle strength in patients with MMN. Although clinical, pathological, imaging, immunological, and electrophysiological studies have improved our understanding of MMN over the past 15 years, further research is needed to elucidate pathogenetic disease mechanisms in the disorder.
AB - Multifocal motor neuropathy (MMN) is an immune-mediated disorder characterised by slowly progressive, asymmetrical weakness of limbs without sensory loss. The clinical presentation of MMN mimics that of lower-motor-neuron disease, but in nerve-conduction studies of patients with MMN motor-conduction block has been found. By contrast with chronic inflammatory demyelinating polyneuropathy, treatment with prednisolone and plasma exchange is generally ineffective in MMN and even associated with clinical worsening in some patients. Of the immunosuppressants, cyclophosphamide has been reported as effective but only anecdotally. Various open trials and four placebo-controlled trials have shown that treatment with high-dose intravenous immunoglobulin leads to improvement of muscle strength in patients with MMN. Although clinical, pathological, imaging, immunological, and electrophysiological studies have improved our understanding of MMN over the past 15 years, further research is needed to elucidate pathogenetic disease mechanisms in the disorder.
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=17444421136&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/15847844
U2 - https://doi.org/10.1016/S1474-4422(05)70074-0
DO - https://doi.org/10.1016/S1474-4422(05)70074-0
M3 - Review article
C2 - 15847844
SN - 1474-4422
VL - 4
SP - 309
EP - 319
JO - Lancet neurology
JF - Lancet neurology
IS - 5
ER -