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Review
. 2015 Dec 22:6:1-12.
doi: 10.2147/DNND.S96258. eCollection 2016.

Human immune globulin infusion in the management of multifocal motor neuropathy

Elizabeth Jovanovich  1 , Chafic Karam  2
Affiliations
Review

Human immune globulin infusion in the management of multifocal motor neuropathy

Elizabeth Jovanovich et al. Degener Neurol Neuromuscul Dis. .

Abstract

Multifocal motor neuropathy (MMN) is a debilitating and rare disease causing profound weakness with minimal to no sensory symptoms. Conduction block is frequently seen on electrodiagnostic testing. An immune-mediated pathology is suspected though the exact underlying pathophysiology has yet to be elucidated. The presence of anti-GM1 ganglioside IgM antibodies coupled with favorable response to intravenous and subcutaneous immunoglobulins supports a complement-mediated mechanism which leads to destruction of nerve tissue with probable predilection to the nodes of Ranvier. High-dose immunoglobulin currently is the only treatment with proven efficacy for MMN patients. Unfortunately, many patients experience decreased responsiveness to immunoglobulins over time, requiring higher and more frequent dosing. In this review, we will focus on the pharmacology, efficacy, safety, and tolerability of intravenous and subcutaneous immune globulin infusion for treatment of MMN.

Keywords: anti-GM1 ganglioside IgM antibodies; conduction block; immunosuppressive therapies; intravenous immunoglobulin; multifocal motor neuropathy; subcutaneous immunoglobulin.

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Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

Figures

Figure 1
Figure 1
Proposed mechanism of IVIG within the classical complement pathway for treatment of multifocal motor neuropathy. Abbreviations: IVIG, intravenous immunoglobulin; MAC, membrane attack complex.
See this image and copyright information in PMC

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