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Diagnosis and treatment of multifocal motor neuropathy.
Curr Treat Options Neurol. 2008 Mar;10(2):103-7.
Kaji R.
Ryuji
Kaji MD, PhD Department of Neurology, Hospital of the University of
Tokushima, 2-chome 5-1, Kuramotocho, Tokushima City, Tokushima,
770-8503, Japan.
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Multifocal
motor neuropathy (MMN) is a unique disease mimicking motor neuron
disease, but it is treatable with intravenous immunoglobulins. Anti-GM1
IgM antibody titers are not sensitive enough to predict the outcome.
Electrodiagnosis is essential for the diagnosis of MMN. Conduction
block has been suggested as the best diagnostic marker, but it is not
found in all treatable cases. Activity-dependent conduction changes, as
revealed by comparing conduction before and after maximal voluntary
contraction of the muscle, are a convenient and promising tool.
Treatment options include various immunosuppressants (including
cyclophosphamide), but there has not been ample evidence in favor of
any of these agents in randomized controlled trials. Intravenous
immunoglobulins remain the mainstay for treating MMN.
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