1. Multifocal motor neuropathy in Austria: a nationwide survey of clinical features and response to treatment
- Author
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Hakan Cetin, Fritz Zimprich, Julia Jecel, Waltraud Kleindienst, Eva Lenzenweger, Marcus Erdler, Dierk Oel, Stefan Quasthoff, Karl Stieglbauer, Klaus Berek, Jakob Rath, Wolfgang Löscher, Susanne Grinzinger, Julia Wanschitz, Wolfgang Örtl, Michael Huemer, Eva-Maria Oberreiter, Isolde Hess, Norbert Embacher, Eva Laich, Raffi Topakian, Petra Müller, Claudia Thaler-Wolf, Valeriu Culea, Klaus Stadler, Corinne G. C. Horlings, and Franz Stefan Höger
- Subjects
Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Pediatrics ,Neurology ,Adolescent ,Conduction block ,Multifocal motor neuropathy ,Anti-GM1 antibody ,Mismatch negativity ,G(M1) Ganglioside ,Nationwide survey ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Atrophy ,Surveys and Questionnaires ,Epidemiology ,Prevalence ,Humans ,Medicine ,Neurologists ,Age of Onset ,Motor Neuron Disease ,Intravenous immunoglobulin ,Aged ,Autoantibodies ,Neuroradiology ,Original Communication ,business.industry ,Middle Aged ,medicine.disease ,Response to treatment ,030104 developmental biology ,Immunoglobulin M ,Austria ,Female ,Neurology (clinical) ,business ,030217 neurology & neurosurgery ,Follow-Up Studies - Abstract
Background and objectives Multifocal motor neuropathy (MMN) is a rare neuropathy and detailed descriptions of larger patient cohorts are scarce. The objective of this study was to evaluate epidemiological, clinical, and laboratory features of MMN patients and their response to treatment in Austria and to compare these data with those from the literature. Methods Anonymized demographic and clinical data about MMN patients until 31.12.2017 were collected from registered Austrian neurologists. Exploratory statistics on clinical and laboratory features as well as treatment regimens and responses were performed. Results 57 Patients with MMN were identified, resulting in a prevalence of 0.65/100.000. Mean age of onset was 44.1 ± 13.1 years, the diagnostic delay 5.5 ± 8.4 years. In 77% of patients, symptom onset was in the upper limbs, and in 92%, it occurred in distal muscles. Proximal onset was never observed in the lower limbs. At the final follow-up, the majority of patients had atrophy (88%) in affected regions. Definite motor conduction blocks (CB) were found in 54 patients. Anti-GM1-IgM antibodies were present in 43%. Treatment with intravenous immunoglobulins improved muscle strength and INCAT score initially, but at last follow-up, both scores deteriorated to values before treatment. Discussion The findings of the present study corroborate the previous findings in MMN. Onset typically occurs in the upper limbs and mostly distal, CBs are found in the majority of cases, while anti-GM1-IgM antibodies are detected in only approximately 40%. Our study underlines that the initial good response to treatment fades over time.
- Published
- 2018
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