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Intravenous immunoglobulin (IVIg) with methylprednisolone pulse therapy for motor impairment of neuralgic amyotrophy: clinical observations in 10 cases.
[neuralgic amyotrophy]
Neuralgic
amyotrophy
(
NA
)
is
a
distinct
peripheral
nervous
system
disorder
characterized
by
attacks
of
acute
neuropathic
pain
and
rapid
multifocal
weakness
and
atrophy
unilaterally
in
the
upper
limb
.
The
current
hypothesis
is
that
the
episodes
are
caused
by
an
immune-mediated
response
to
the
brachial
plexus
,
however
,
therapeutic
strategies
for
NA
have
not
been
well
established
.
We
retrospectively
reviewed
15
case
series
of
NA
;
10
of
the
15
patients
received
intravenous
immunoglobulin
(
IVIg
)
with
methylprednisolone
pulse
therapy
(
MPPT
)
and
9
of
these
0
patients
showed
clinical
improvement
of
motor
impairment
.
Our
clinical
observations
do
not
contradict
the
possibility
that
IVIg
with
MPPT
may
be
one
of
the
potential
therapeutics
for
NA
,
however
the
efficacy
remains
to
be
established
.
Further
confirmatory
trials
are
needed
in
patients
with
various
clinical
severities
and
phases
of
NA
.
Further
basic
research
and
confirmatory
trials
should
be
performed
to
survey
the
efficacy
of
such
immunomodulation
therapy
for
NA
.