Article
Immunology
Vittorio Mantero, Paola Basilico, Paolo Borelli, Antonio Cappello, Andrea Salmaggi, Andrea Rigamonti
Summary: Multifocal motor neuropathy is a motor neuropathy possibly caused by dysimmune factors, with some cases showing presence of anti-GM1 IgM antibodies. Early diagnosis and treatment of dysimmune mononeuropathy with IVIg are crucial for substantial improvement in symptoms.
JOURNAL OF NEUROIMMUNOLOGY
(2021)
Article
Clinical Neurology
Marianna Di Egidio, Cristian R. R. Bacaglio, Rocio Arrejoria, Andres M. Villa, Gustavo A. A. Nores, Pablo H. H. Lopez
Summary: Multifocal motor neuropathy (MMN) is a peripheral nerve disorder characterized by progressive muscle weakness. IgM anti-GM1 antibodies play a direct role in the disease process. We found an immunoregulatory mechanism mediated by IgG antibodies in MMN patients, leading to a lack of natural reactivity against GM1.
JOURNAL OF THE PERIPHERAL NERVOUS SYSTEM
(2023)
Article
Clinical Neurology
Jaap N. E. Bakers, Ruben P. A. van Eijk, Leonard H. van den Berg, Johanna M. A. Visser-Meily, Anita Beelen
Summary: The study shows that IVIg treatment can improve muscle strength in both distal and proximal muscle groups in MMN patients, with the largest response observed in muscle groups that are initially the weakest.
Article
Clinical Neurology
Ali Al-Zuhairy, Soren H. Sindrup, Johannes Jakobsen
Summary: The study showed that long-term subcutaneous immunoglobulin therapy is feasible, effective and well-received by patients with multifocal motor neuropathy, as it resulted in maintained isometric strength, unaltered ODSS scores, and non-inferior secondary variables compared to baseline values.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2021)
Article
Geriatrics & Gerontology
Jeroen W. Bos, Henny G. Otten, Ingrid J. T. Herraets, H. Stephan Goedee, E. A. Cats, Talitha de Hoop, Willem Verduijn, W. Ludo van der Pol, Leonard H. van den Berg
Summary: The study found that MMN patients were more likely to have the DRB1*15:01-DQB1*06:02 and DRB1*12:01-DQB1*03:01 haplotypes, but these haplotypes were not associated with disease course, treatment response, or anti-ganglioside antibodies.
NEUROBIOLOGY OF AGING
(2021)
Article
Clinical Neurology
Francois Ochsner, Laurent Tatu
Summary: Multifocal motor neuropathy (MMN) is a rare neurological condition characterized by asymmetric muscle weakness and cramping, with spontaneous motor unit activity but without sensory disorder. The recognition of MMN by the medical community was a long and winding process, with the first scientific publication on the subject written by Gerard Roth and his colleagues.
EUROPEAN NEUROLOGY
(2021)
Article
Clinical Neurology
Diederik J. L. Stikvoort Garcia, Maria O. Kovalchuk, H. Stephan Goedee, Leonard J. van Schelven, Leonard H. van den Berg, Hessel Franssen, Boudewijn T. H. M. Sleutjes
Summary: In this study, it was found that CMAP(max) and MUNE were reduced in patients with multifocal motor neuropathy (MMN), while the largest MU amplitude was increased. Presence of anti-GM1 antibodies was associated with an increased relative range of MU thresholds and a reduction in largest MU amplitude. The findings suggest that CMAP scans could complement routine nerve conduction studies and potentially be used for monitoring treatment efficacy and disease progression.
Review
Neurosciences
Stefano Tozza, Emanuele Spina, Aniello Iovino, Rosa Iodice, Raffaele Dubbioso, Lucia Ruggiero, Maria Nolano, Fiore Manganelli
Summary: Chronic dysimmune neuropathies are a group of neuropathies that are mediated by the immune system. Antibody-related neuropathies such as anti-MAG neuropathy, multifocal motor neuropathy, and neuropathies related to immune attack against paranodal antigens have distinct pathomechanisms, clinical features, and treatment response compared to chronic inflammatory demyelinating polyradiculoneuropathy and its variants. This review provides an overview of the antibody-mediated neuropathies, highlighting the pathomechanisms, clinical characteristics, electrophysiological and biochemical features, and treatment response, aiming to guide the search for antibodies in chronic dysimmune neuropathies.
Article
Clinical Neurology
Jeroen W. Bos, Ewout J. N. Groen, Kevin Budding, Eveline M. Delemarre, H. Stephan Goedee, Edward F. Knol, Leonard H. van den Berg, W. Ludo van der Pol
Summary: This study aimed to further understand the risk factors and disease modifiers of MMN by studying the innate immune responses to endotoxin in patients with MMN and controls. The results showed no significant differences in immune responses to endotoxin between the two groups, suggesting that altered endotoxin-induced innate immune responses are unlikely to be a susceptibility factor for MMN.
JOURNAL OF THE NEUROLOGICAL SCIENCES
(2023)
Letter
Clinical Neurology
Steven Galetta, Aravind Ganesh, Ariane Lewis, James E. Siegler
Summary: This article compared the effectiveness of IVIG and placebo in patients with idiopathic small fiber neuropathy and found no significant difference in pain intensity rating. In a discussion, concerns were raised about the use of IVIG in patients with autoimmune SFN. The authors responded with additional data and suggested the need for further research on the role of IVIG in autoimmune SFN.
Article
Clinical Neurology
Stefano Pro, Fabiana Ursitti, Gian Luca Pruneddu, Matteo Di Capua, Massimiliano Valeriani
Summary: This case report discusses the 3-year follow-up of a 13-year-old girl with MMN, who showed no improvement after treatment with IVIg. While childhood onset MMN is rare, most patients in literature respond to IVIg treatment.
Article
Clinical Neurology
Miguel Saucedo, Luciana Leon-Cejas, Cintia Marchesoni, Ana Pardal, Ricardo Reisin
Summary: Multifocal motor neuropathy (MMN) is a chronic progressive immune-mediated neuropathy that primarily affects the upper limbs asymmetrically with motor conduction block. Immunoglobulin (Ig) is the preferred treatment, but some patients may develop resistance. We present a case of a MMN patient who became resistant to gammaglobulin treatment but showed remarkable improvement with ultra-high doses of intravenous immunoglobulin.
REVISTA DE NEUROLOGIA
(2023)
Article
Clinical Neurology
Naohiro Mouri, Haruki Koike, Yuki Fukami, Mie Takahashi, Satoru Yagi, Soma Furukawa, Masashi Suzuki, Yoshiyuki Kishimoto, Kenichiro Murate, Takamasa Nukui, Tamaki Yoshida, Yosuke Kudo, Mikiko Tada, Yuichi Higashiyama, Hirohisa Watanabe, Yuji Nakatsuji, Fumiaki Tanaka, Masahisa Katsuno
Summary: In this study, the clinicopathological features of sarcoid neuropathy were examined through electrophysiological and histopathological analysis of sural nerve biopsy samples. The results showed that patients with sarcoid neuropathy often exhibited conduction block, leading to them meeting the electrophysiological criteria for chronic inflammatory demyelinating polyneuropathy (CIDP) as defined by the European Academy of Neurology/Peripheral Nerve Society (EAN/PNS). Additionally, demyelination may play a crucial role in the mechanism underlying sarcoid neuropathy, in addition to ischemic damage caused by granulomatous inflammation.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Mario B. Prado, Karen Joy B. Adiao
Summary: Approximately 40% of patients with multifocal motor neuropathy had anti-GM1 IgM antibodies, while only 1 out of 88 patients had anti-GM1 IgG antibodies. The presence of concomitant anti-GM IgG and anti-GM1 IgM may lead to an MMN with more severe axonal loss.
Article
Medicine, General & Internal
Krithika Suresh, Preethi Mereddy, Nicholas Lanciano, Md Didar Ul Alam
Summary: Multifocal motor neuropathy (MMN) is a peripheral nerve disorder characterized by progressive weakness, mainly in the distal limbs, with minimal or no sensory impairment. This condition is associated with the presence of antibodies, primarily IgM, against gangliosides, particularly GM1 ganglioside. We present a case of MMN in a patient who developed symptoms of paresthesia and limb weakness shortly after receiving the influenza vaccine and was found to have high levels of anti-GM1 IgM antibodies. Initial treatment with IVIG was unsuccessful, but plasma exchange was effective in achieving remission.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2022)
