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Do A-waves help predict intravenous immunoglobulin response in multifocal motor neuropathy without block?
MedLine Citation:
PMID:  21305570     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Introduction: Are there electrophysiological findings that predict response to intravenous immunoglobulin (IVIg) in patients with lower motor neuron (LMN) syndromes without multifocal conduction block (MCB)? Methods: We enrolled 9 patients with LMN syndromes without MCB to receive 18 weeks of IVIg therapy. Response was measured at weeks 2 and 18 using the Appel Amyotrophic Lateral Sclerosis (AALS) score (includes grip and pincer strength measures), ALS Functional Rating Scale (ALSFRS), and electrophysiological measures, including motor unit estimates (MUNEs). Results: No change occurred in AALS or ALSFRS scores posttreatment. Grip/pincer strength increased in 7 patients (P = 0.028) after initial treatment (responders); 2 showed no improvement (non-responders). No electrophysiological measure changed after treatment in either group but MUNEs trended higher (P = 0.055). "Abnormal A-waves" (complex, repetitive biphasic, or present in multiple nerves) occurred in pretreatment studies more often in responders (P = 0.028).Discussion:"Abnormal A-waves" may signal IVIg-responsive LMN syndromes even if conduction block is absent. Muscle Nerve, 2011.
Authors:
Dale J Lange; Rajwinder Nijjar; Andrei Voustianiouk; Gregory Seidel; Janki Panchal; Annabel K Wang
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-2-8
Journal Detail:
Title:  Muscle & nerve     Volume:  -     ISSN:  1097-4598     ISO Abbreviation:  -     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-2-9     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803146     Medline TA:  Muscle Nerve     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 Wiley Periodicals, Inc.
Affiliation:
Department of Neurology, Division of Neuromuscular Disease, Mount Sinai School of Medicine, New York, New York, USA. langed@hss.edu.
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