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Controversies in Neurology
August 1999

Intravenous Immunoglobulin Treatment in Neurologic DisordersYes

Author Affiliations

From the Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark.



Arch Neurol. 1999;56(8):1025-1027. doi:10.1001/archneur.56.8.1025

HIGH-DOSE intravenous immunoglobulin (IVIG) is increasingly used as a treatment for immune-mediated neurologic diseases. Clinical effect has been shown in controlled trials in patients with Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, multifocal motor neuropathy, dermatomyositis, and multiple sclerosis, and there is accumulating evidence of a beneficial effect in other neurologic diseases.

Plasma exchange and IVIG are effective therapies for Guillain-Barré syndrome. In randomized controlled trials comparing plasma exchange and IVIG 0.4 g/kg daily for 5 days, both treatments were equally effective in restoring motor function and as effective as the combination of plasma exchange and IVIG.13Early relapse after an initial response to plasma exchange or IVIG is seen in approximately 10% of treated patients, for whom another treatment cycle should be given.25There is no consensus on whether the original regimen should be repeated or an alternate therapy tried.

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