HACHINSKIVLADIMIRMD, FRCPC, DSC
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.1- 3Early 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.2- 5There is no consensus on whether the original regimen should be repeated or an alternate therapy tried.
Sorensen PS. Intravenous Immunoglobulin Treatment in Neurologic DisordersYes. Arch Neurol. 1999;56(8):1025-1027. doi:10.1001/archneur.56.8.1025