Immunoglobulins in neurological practice: a review of the literature

Abstract

Today intravenous immunoglobulins are used increasingly in the management of patients with neurological conditions. The efficacy and safety of intravenous immunoglobulins treatment in chronic inflammatory demyelinating polyradiculoneuropathy, Guillain–Barre syndrome and multifocal motor neuropathy have been established in randomized controlled trials and declared in systematic reviews. There are discussions about the dose, timing, duration and necessity of repeated infusions in these disorders. The intravenous immunoglobulins treatment is an option in myasthenia gravis crisis and exacerbations the disease, stiff-person syndrome, a second-line therapy in dermatomyositis and some patients with polymyositis. The use of intravenous immunoglobulins in patients with multiple sclerosis, inclusion body myositis, resistant epilepsy is not finally proved. The review discussed the data of immunoglobulins efficacy in neurological disorders based on informative studies with an emphasis on the main criteria for choosing a drug for effective high-dose intravenous immunotherapy.

Keywords

• intravenous immunoglobulin
• chronic inflammatory demyelinating polyneuropathy
• guillain–barre syndrome
• multifocal motor neuropathy
• dermatomyositis
• multiple sclerosis
• epilepsy
• autoimmune disorders