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Immunosuppressive Treatment of Motor Neuron Syndromes

Alan Pestronk, MD
Arch Neurol. 1995;52(3):230-230. doi:10.1001/archneur.1995.00540270016004
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The article on the treatment of motor neuron syndromes by Tan et al1 contains inaccurate statements regarding methods used to measure and report anti—GM1 ganglioside antibodies in our laboratory. The results reported by our laboratory correspond closely to the reciprocal of true dilutions. This is stated in the "Methods" section of each of our articles.2,3 We have participated in two international validation studies.4,5 These studies show that our results correlate with those from other laboratories that express their results as titers. It is highly unlikely that serum samples with a titer measured at 1:200 in their laboratory would be reported at 64000 by ours. Such high titers are rare in patients with lower motor neuron syndromes.2 The citation in the "Methods" section of the article by Tan et al of a serum with a titer of 1:64000 was not data from our laboratory as we

REFERENCES

Tan T, Lynn J, Amato M, et al.  Immunosuppressive treatment of motor neuron syndromes: attempts to distinguish a treatable disorder . Arch Neurol . 1994;; 51:194-200.
Pestronk A, Chaudhry V, Feldman EL, et al.  Lower motor neuron syndromes defined by patterns of weakness, nerve conduction abnormalities, and high titers of antiglycolipid antibodies . Ann Neurol . 1990;;27:316-326.
Pestronk A, Cornblath DR, Ilyas M, et al.  A treatable multifocal motor neuropathy with antibodies to GM1 ganglioside . Ann Neurol . 1988;;24:73-78.
Marcus DM, Latov N, Hsi BP, Gillard BK.  Measurement and significance of antibodies against GM1 ganglioside: report of a workshop, 18 April 1989, Chicago, IL, USA . J Neuroimmunol . 1989;;25:255-259.
Zielasek J, Ritter G, Magi S, Hartung HP, Toyka KV, participating laboratories.  A comparative trial of anti-glycoconjugate antibody assays: IgM antibodies to GM1 . J Neurol . 1994;;241:475-480.
Sadiq SA, Thomas FP, Kilidireas K, et al.  The spectrum of neurologic disease associated with anti-GM1 antibodies . Neurology . 1990;;40:1067-1072.
Pestronk A, Lopate G, Kornberg AJ, et al. Distal lower motor neuron syndrome with high titer serum IgM anti-GM1 antobodies: improvement following immunotherapy with monthly plasma exchange and intravenous cyclophosphamide. Neurology. In press.

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Tan T, Lynn J, Amato M, et al.  Immunosuppressive treatment of motor neuron syndromes: attempts to distinguish a treatable disorder . Arch Neurol . 1994;; 51:194-200.
Pestronk A, Chaudhry V, Feldman EL, et al.  Lower motor neuron syndromes defined by patterns of weakness, nerve conduction abnormalities, and high titers of antiglycolipid antibodies . Ann Neurol . 1990;;27:316-326.
Pestronk A, Cornblath DR, Ilyas M, et al.  A treatable multifocal motor neuropathy with antibodies to GM1 ganglioside . Ann Neurol . 1988;;24:73-78.
Marcus DM, Latov N, Hsi BP, Gillard BK.  Measurement and significance of antibodies against GM1 ganglioside: report of a workshop, 18 April 1989, Chicago, IL, USA . J Neuroimmunol . 1989;;25:255-259.
Zielasek J, Ritter G, Magi S, Hartung HP, Toyka KV, participating laboratories.  A comparative trial of anti-glycoconjugate antibody assays: IgM antibodies to GM1 . J Neurol . 1994;;241:475-480.
Sadiq SA, Thomas FP, Kilidireas K, et al.  The spectrum of neurologic disease associated with anti-GM1 antibodies . Neurology . 1990;;40:1067-1072.
Pestronk A, Lopate G, Kornberg AJ, et al. Distal lower motor neuron syndrome with high titer serum IgM anti-GM1 antobodies: improvement following immunotherapy with monthly plasma exchange and intravenous cyclophosphamide. Neurology. In press.

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