Comi G, Amadio S, Galardi G, Fazio R, Nemni R
Scientific Institute Ospedale San Raffaele, University of Milan, Italy.
J Neurol Neurosurg Psychiatry. 1994 Nov;57 Suppl(Suppl):35-7. doi: 10.1136/jnnp.57.suppl.35.
High dose intravenous immunoglobulin (IVIg) is an effective treatment for demyelinating neuropathies. IVIg was given to five patients with multifocal motor neuropathy, a motor neuropathy showing a clinical syndrome of asymmetrical weakness and amyotrophy, electrophysiological evidence of motor conduction block and, in many cases, high titres of serum anti-GM1 antibodies. Muscle strength was evaluated by a conventional score before and after each IVIg course. In all patients there was relevant improvement on muscle strength after each immunoglobulin course, but in most cases the clinical benefits partially declined after three to eight weeks. At the eight month follow up, however, the pretreatment examination showed a significant improvement compared with the initial evaluation. The effects of each IVIg course were still present after a number of courses. Electrophysiological study revealed a decrease in conduction block in one or more nerves in all patients. However, conduction block was unchanged or increased in other sites. IVIg treatment did not affect anti-GM1 antibody titres.
大剂量静脉注射免疫球蛋白（IVIg）是治疗脱髓鞘性神经病的有效方法。对5例多灶性运动神经病患者给予IVIg治疗，多灶性运动神经病是一种运动神经病，表现为不对称性肌无力和肌萎缩的临床综合征、运动传导阻滞的电生理证据，且在许多病例中血清抗GM1抗体滴度较高。在每个IVIg疗程前后，通过传统评分评估肌肉力量。所有患者在每个免疫球蛋白疗程后肌肉力量均有显著改善，但在大多数情况下，临床获益在三至八周后部分下降。然而，在八个月的随访中，与初始评估相比，预处理检查显示有显著改善。经过多个疗程后，每个IVIg疗程的效果仍然存在。电生理研究显示，所有患者一条或多条神经的传导阻滞均有减轻。然而，其他部位的传导阻滞未改变或增加。IVIg治疗不影响抗GM1抗体滴度。
