Intravenous Immunoglobulin (IVIg) with Methylprednisolone Pulse Therapy for Motor Impairment of Neuralgic Amyotrophy: Clinical Observations in 10 Cases

  • Naito Ko-suke
    Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan
  • Fukushima Kazuhiro
    Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan
  • Suzuki Seiko
    Department of Neurology, Kinki University School of Medicine, Japan
  • Kuwahara Motoi
    Department of Neurology, Kinki University School of Medicine, Japan
  • Morita Hiroshi
    Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan
  • Kusunoki Susumu
    Department of Neurology, Kinki University School of Medicine, Japan
  • Ikeda Shu-ichi
    Department of Medicine (Neurology and Rheumatology), Shinshu University School of Medicine, Japan

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Description

Background Neuralgic amyotrophy (NA) is a distinct peripheral nervous system disorder characterized by attacks of acute neuropathic pain and rapid multifocal weakness and atrophy unilaterally in the upper limb. The current hypothesis is that the episodes are caused by an immune-mediated response to the brachial plexus, however, therapeutic strategies for NA have not been well established.<br> Methods and Results We retrospectively reviewed 15 case series of NA; 10 of the 15 patients received intravenous immunoglobulin (IVIg) with methylprednisolone pulse therapy (MPPT) and 9 of these10 patients showed clinical improvement of motor impairment.<br> Conclusion Our clinical observations do not contradict the possibility that IVIg with MPPT may be one of the potential therapeutics for NA, however the efficacy remains to be established. Further confirmatory trials are needed in patients with various clinical severities and phases of NA. Further basic research and confirmatory trials should be performed to survey the efficacy of such immunomodulation therapy for NA.<br>

Journal

  • Internal Medicine

    Internal Medicine 51 (12), 1493-1500, 2012

    The Japanese Society of Internal Medicine

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