Immunotherapy of multifocal motor neuropathy.

INTRODUCTION: Multifocal motor neuropathy (MMN) is an immune-mediated disease, which usually runs a chronic course. Current treatments are aiming at modulation of the immune response to maintain functional status. Although patients can remain stable with prolonged maintenance intravenous immunoglobuin (IVIg) treatment, most patients slowly deteriorate over many years despite increasing IVIg doses. AREAS COVERED: The paper identifies studies since 1985 for patients with MMN. Randomised and non-randomized studies examining the effects of any therapeutic agent were selected, to give a full overview of the different treatments for MMN. The review provides a treatment algorithm together with our views on current treatments, ongoing trials and possible directions for further research. EXPERT OPINION: IVIg remains the only proven treatment for MMN, although questions around dosages and duration of treatment remain. The presence of an effective therapy for MMN should not discourage but stimulate further research into alternative treatments as ongoing axonal damage results in increasing impairment in patients with MMN.