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Multifocal motor neuropathy: controversies and priorities
journal contributionposted on 2023-05-20, 16:09 authored by Yeh, WZ, Dyck, PJ, van den Berg, LH, Kiernan, MC, Bruce TaylorBruce Taylor
Despite 30 years of research there are still significant unknowns and controversies associated with multifocal motor neuropathy (MMN) including disease pathophysiology, diagnostic criteria and treatment. Foremost relates to the underlying pathophysiology, specifically whether MMN represents an axonal or demyelinating neuropathy and whether the underlying pathophysiology is focused at the node of Ranvier. In turn, this discussion promotes consideration of therapeutic approaches, an issue that becomes more directed in this evolving era of precision medicine. It is generally accepted that MMN represents a chronic progressive immune-mediated motor neuropathy clinically characterised by progressive asymmetric weakness and electrophysiologically by partial motor conduction block. Anti-GM1 IgM antibodies are identified in at least 40% of patients. There have been recent developments in the use of neuromuscular ultrasound and MRI to aid in diagnosing MMN and in further elucidation of its pathophysiological mechanisms. The present Review will critically analyse the knowledge accumulated about MMN over the past 30 years, culminating in a state-of-the-art approach to therapy.
Publication titleJournal of Neurology, Neurosurgery and Psychiatry
Department/SchoolMenzies Institute for Medical Research
PublisherB M J Publishing Group
Place of publicationBritish Med Assoc House, Tavistock Square, London, England, Wc1H 9Jr
Rights statement© Author(s) (or their employer(s)) 2020.