Acute motor response following a single IVIG treatment course in chronic inflammatory demyelinating polyneuropathy

Muscle Nerve. 2009 Apr;39(4):439-47. doi: 10.1002/mus.21305.

Abstract

In chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), the acute motor response following withdrawal and reestablishment of intravenous immunoglobulin (IVIG) therapy was studied. In a prospectively designed case series 11 CIDP patients in IVIG maintenance therapy were assessed with isokinetic dynamometry, nerve conduction studies, and functional tests. After short-term withdrawal of IVIG, eight treatment-responsive patients had a 14.2% (8.6-20.0) loss of isokinetic strength of 12 muscle groups. Three patients remained stable without treatment and were excluded from further study. On days 5 and 10 after reinitiation of IVIG therapy isokinetic muscle strength increased by 5.5% (1.6-9.6) and 11.9% (7.5-16.5), respectively, but there was no further increase at day 15. Improvement of walking velocity and hand function coincided. The minimal F-wave latency shortened, whereas other electrophysiological parameters remained unchanged. In conclusion, isokinetic dynamometry is a sensitive and clinically relevant method for monitoring the acute response to IVIG treatment in CIDP.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Immunoglobulins, Intravenous / adverse effects
  • Immunologic Factors / administration & dosage*
  • Immunologic Factors / adverse effects
  • Isotonic Contraction / drug effects
  • Isotonic Contraction / physiology
  • Male
  • Middle Aged
  • Motor Neurons / physiology
  • Muscle Strength / drug effects*
  • Muscle Strength / physiology
  • Muscle Strength Dynamometer
  • Neural Conduction / drug effects
  • Neural Conduction / physiology
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / diagnosis
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / drug therapy*
  • Polyradiculoneuropathy, Chronic Inflammatory Demyelinating / physiopathology*
  • Prospective Studies
  • Quality of Life
  • Sensory Receptor Cells / physiology
  • Substance Withdrawal Syndrome / diagnosis
  • Substance Withdrawal Syndrome / physiopathology
  • Treatment Outcome
  • Young Adult

Substances

  • Immunoglobulins, Intravenous
  • Immunologic Factors