The clinical value of therapeutic plasma exchange in multifocal motor neuropathy.

Abstract:

OBJECTIVE:Although there is evidence for a pathogenic role of humoral factors in multifocal motor neuropathy (MMN), plasma exchange (PE) is assumed to be an ineffective treatment. We set out to elucidate possible reasons for this apparent contradiction. METHODS:A retrospective analysis of seven patients with MMN, who underwent 4 to 18 sessions of PE. Clinical response, electrophysiological parameter and anti-ganglioside antibody titers were reviewed. RESULTS:Two patients, who had anti-ganglioside antibodies, exhibited transient clinical responses to PE, manifested by improved neurological function. Whereas electrophysiological parameters continued to worsen in all patients, anti-ganglioside antibody titers declined during PE, but increased after PE. CONCLUSION:PE is of limited therapeutic value in patients with MMN, who do not respond to established treatment options. It may only be useful as an adjunctive treatment in a subset of patients. The transient decrease of anti-ganglioside-antibodies titers suggests that pathogenic humoral factors in MMN are only temporarily reduced. Further, PE treatment alone is insufficient to prevent axons from continuing degeneration, which may explain the failure of PE to substantially influence the disease course of patients with MMN.

journal_name

J Neurol Sci

authors

Lehmann HC,Hoffmann FR,Fusshoeller A,Meyer zu Hörste G,Hetzel R,Hartung HP,Schroeter M,Kieseier BC

doi

10.1016/j.jns.2008.02.022

subject

Has Abstract

pub_date

2008-08-15 00:00:00

pages

34-9

issue

1-2

eissn

0022-510X

issn

1878-5883

pii

S0022-510X(08)00100-7

journal_volume

271

pub_type

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