Controversies in Neurology |

Intravenous Immunoglobulin Treatment in Neurologic Disorders

Vladimir Hachinski, MD, FRCPC, DSc
Arch Neurol. 1999;56(8):1032. doi:10.1001/archneur.56.8.1032.
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A THERAPY used in a variety of disorders is bound to yield varying results. Sorensen thinks that intravenous immunoglobulin (IVIG) treatment is effective in Guillain-Barré syndrome. Karussis and Abramsky consider it an inferior choice that should be used only when plasmapheresis is contraindicated or unavailable. Sorensen thinks that IVIG should be used in chronic inflammatory demyelinating polyneuropathy. Karussis and Abramsky acknowledge this, but point out that some patients do not respond to IVIG, that the therapeutic effect fades in others, and that steroids remain the treatment-of-choice followed by plasmapheresis. All contributors agree that there is a role for IVIG in dermatomyositis and multifocal motor neuropathy. Its use in myasthenia gravis and Lambert-Eaton syndrome is less well founded, speculative in multiple sclerosis, and hazardous in neuromyotonia.

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