IVIg Rapidly Resolve Functional Conduction Blocks-A Serial Analysis of Conduction Blocks after IVIg in a Case of CIDP-
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Accession number;06A0292928
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| Title;IVIg Rapidly Resolve Functional Conduction Blocks-A Serial Analysis of Conduction Blocks after IVIg in a Case of CIDP- |
| Author;
NAKAMURA YUKO
(Jichi Medical School, Dep. Medicine, JPN)
SAWADA MIKIO
(Jichi Medical School, Dep. Medicine, JPN)
SHIMAZAKI HARUO
(Jichi Medical School, Dep. Medicine, JPN)
MORITA MITSUYA
(Jichi Medical School, Dep. Medicine, JPN)
NAKANO IMAHARU
(Jichi Medical School, Dep. Medicine, JPN)
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Journal Title;Neurological Therapeutics
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Journal Code:X0110A
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ISSN:0916-8443
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VOL.23;NO.1;PAGE.57-61(2006)
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| Figure&Table&Reference;FIG.2, REF.10 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;We described a serial examination of nerve conduction blocks in a 51-year-old woman developing muscular weakness over 2 months. On admission, she was bed-ridden with symmetric proximal and distal weakness, areflexia and dysesthesia in both soles. Motor nerve conduction studies revealed conduction blocks, reduced conduction velocity and prolonged F-wave latency, leading to a diagnosis of chronic inflammatory demyelinating polyneuropathy (CIDP). An intravenous immunoglobulin (IVIg) was started, followed by oral steroid administration on the 6th day of the treatment initiation. In the left ulnar nerve, nerve conduction studies focussed on conduction blocks were performed weekly to clarify the pathophysiological mechanisms of IVIg. The clinical improvement started as fast as 3 day after IVIg, and she became able to walk on the 14th day. Because she showed weakness again, however, on the 36th day after the 1st IVIg, she was treated by IVIg again. After the 2nd IVIg, a favorable response was achieved and her symptoms completely recovered within 5 days to the level before the relapse. Interestingly, her whole clinical course, including the relapse, correlated clearly with the degree of the conduction block confined to the section between the axilla and the Erb's point of the left ulnar nerve. Serial clinical and electrophysiological findings of this case suggest that (1) the rapid clinical recovery and the rapid worsening are due to functional conduction blocks and their resolution rather than organic demyelination and remyelination, (2) some conduction blocks can be rapidly and successfully treated by IVIg, and (3) once a nerve segment undergoes conduction blocks, it may become a locus minoris to the similar insults thereafter. (author abst.) |
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