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Intravenous Immunoglobulin Treatment in Neurologic Disorders
Yes
Per Soelberg Sorensen, MD, DMSc
From the Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.
Arch Neurol. 1999;56:1025-1027.
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HIGH-DOSE intravenous immunoglobulin (IVIG) is increasingly used as a treatment for immune-mediated neurologic diseases. Clinical effect has been shown in controlled trials in patients with Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy, dermatomyositis, and multiple sclerosis, and there is accumulating evidence of a beneficial effect in other neurologic diseases.
GUILLAIN-BARRÉ SYNDROME
Plasma exchange and IVIG are effective therapies for Guillain-Barré syndrome. In randomized controlled trials comparing plasma exchange and IVIG 0.4 g/kg daily for 5 days, both treatments were equally effective in restoring motor function and as effective as the combination of plasma exchange and IVIG.1-3 Early relapse after an initial response to plasma exchange or IVIG is seen in approximately 10% of treated patients, for whom another treatment cycle should be given.2-5 There is no consensus on whether the original regimen should be repeated or an alternate therapy tried.
It has been suggested that . . . [Full Text of this Article]
CHRONIC INFLAMMATORY DEMYELINATING POLYNEUROPATHY
MULTIFOCAL MOTOR NEUROPATHY
NEUROMUSCULAR TRANSMISSION DISORDERS
INFLAMMATORY MYOPATHIES
MULTIPLE SCLEROSIS
SAFETY OF IVIG
CONCLUSIONS
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