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【medical-news】免疫球蛋白用于多灶性运动神经病
Certain patients with multifocal motor neuropathy with or without apparent conduction block respond to IV immunoglobulin (IVIg) therapy, according to French researchers.
"This study shows that clinical judgment remains the gold standard in diagnosis of multifocal motor neuropathies," lead investigator Dr. Emilien Delmont told Reuters Health.
"Hence, a trial of IVIg may be prescribed for selected patients presenting with chronic asymmetric motor weakness with a peripheral nerve distribution without any conduction block being detected in the nerve conduction study," he added.
In the August issue of Neurology, Dr. Delmont of Hopital Pasteur, Nice and colleagues note that they came to this conclusion after studying data on 20 such patients with conduction block and 13 without. They had been followed for more than 4 years. All had asymmetric motor weakness without sensory, bulbar or respiratory signs, and no upper motor neuron involvement.
Few significant differences were seen between groups, but involvement of the median nerve was significantly less frequent in patients without conduction block. This was also true of proximal weakness.
The efficacy of IVIG was similar in both groups, with responses in 8 (61%) of patients without conduction block and 14 (70%) with conduction block.
Dr. Vinay Chaudhry of Johns Hopkins University School of Medicine, Baltimore, Maryland, author of an accompanying editorial, told Reuters Health that he agreed with the approach.
"A trial of IVIg may be justified in patients with progressive distal asymmetric weakness in a multifocal peripheral nerve distribution even if they don't have conduction block on nerve conduction studies," he said.
请同时翻译以下摘要
Multifocal motor neuropathy with and without conduction block: a single entity?
OBJECTIVE: To assess if multifocal motor neuropathy (MMN) with and MMN without conduction block (CB) are similar or distinct diseases. METHODS: The authors reviewed the clinical features and responses to IV immunoglobulin (IVIg) treatment of patients with MMN with and without CB at diagnosis, after 4 years of follow-up and at the last examination. They included all patients showing clinical features of MMN who had been followed for at least 4 years: All had asymmetric purely motor weakness with a peripheral nerve distribution, without any sensory, bulbar, or respiratory signs and without any upper motor neuron involvement. RESULTS: Twenty patients had CB and 13 had no CB. Median follow-up time was 7 years. There were no differences between the two groups in term of age, sex, time from onset to diagnosis, anti-GM1 antibody titers, or CSF data. Nerve distribution, number of affected limb regions, predominant weakness in distal upper extremities, asymmetric weakness, cramps, fasciculations, and Medical Research Council sum-scores in upper and lower limbs were comparable at diagnosis, 4 years of follow-up, and last examination. Few significant differences were observed. Involvement of median nerve was less frequent at 4 years of follow-up (14/20 vs 4/13; p = 0.027) and at the last examination (17/20 vs 5/13; p = 0.009) in patients without CB. Proximal weakness was less frequent in patients with MMN without CB at the last examination (7/20 vs 0/13; p = 0.027). Fewer nerves were involved in patients without CB at the last examination (4.5 vs 2; p = 0.04). Efficacy of IVIg was similar in MNN patients without CB (8/13) and with CB (14/20; p > 0.05). CONCLUSION: After a median follow-up time of 7 years, patients with and without conduction block showed similar clinical features and a similar response to IV immunoglobulin treatment.
PMID: 16924010 renlingzhi http://www.medscape.com/viewarticle/544634
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Immunoglobulin May Be Useful in Multifocal Motor Neuropathy
免疫球蛋白可以用于治疗多灶性运动神经病
Certain patients with multifocal motor neuropathy with or without apparent conduction block respond to IV immunoglobulin (IVIg) therapy, according to French researchers.
根据法国研究者的结果，某些多灶性运动神经病患者，无论有无外在传导阻滞症状，都可以对免疫球蛋白IV作出反应。
"This study shows that clinical judgment remains the gold standard in diagnosis of multifocal motor neuropathies," lead investigator Dr. Emilien Delmont told Reuters Health.
该研究的首席科学家Emilien Delmont博士说：“这表明临床判断仍然是诊断多灶性运动神经病的金标准。
"Hence, a trial of IVIg may be prescribed for selected patients presenting with chronic asymmetric motor weakness with a peripheral nerve distribution without any conduction block being detected in the nerve conduction study," he added.
因此，IVIg或许可以作为处方药供慢性非对称运动肌无力的备选病人使用。即使这些病人经神经传导测试检测其外周神经分布并无传导阻滞症状。
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作者:admin@医学,生命科学 2011-01-04 17:14
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