Canomad presenting without ophthalmoplegia and responding to intravenous immunoglobulin

Muscle Nerve. 2011 Nov;44(5):829-33. doi: 10.1002/mus.22167.


The acronym CANOMAD encompasses chronic ataxic neuropathy combined with ophthalmoplegia, M protein, cold agglutinins, and anti-disialosyl antibodies.Herein we describe 2 patients presenting with progressive ataxic neuropathy who only developed ophthalmoplegia after a significant delay post-presentation, which in 1 case had features indicative of brainstem dysfunction. Both patients were found to have an IgM paraprotein and anti-disialosyl antibodies. They responded to treatment with intravenous immunoglobulin, thus illustrating the importance of diagnosing this condition.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Anemia, Hemolytic, Autoimmune / diagnosis*
  • Anemia, Hemolytic, Autoimmune / drug therapy*
  • Anemia, Hemolytic, Autoimmune / physiopathology
  • Ataxia / diagnosis*
  • Ataxia / drug therapy*
  • Ataxia / physiopathology
  • Diagnosis, Differential
  • Female
  • Humans
  • Immunoglobulins, Intravenous / administration & dosage*
  • Male
  • Ophthalmoplegia / diagnosis*
  • Ophthalmoplegia / drug therapy*
  • Ophthalmoplegia / physiopathology


  • Immunoglobulins, Intravenous

Supplementary concepts

  • CANOMAD syndrome