EFNS guidelines for the use of intravenous immunoglobulin in treatment of neurological diseases: EFNS task force on the use of intravenous immunoglobulin in treatment of neurological diseases

I. Elovaara, S. Apostolski, P. van Doorn, N.E. Gilhus, A. Hietaharju, J. Honkaniemi, Schaik,I van, N. Scolding, B. Udd, Per Soelberg Sørensen

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

    245 Citationer (Scopus)

    Abstract

    Despite high-dose intravenous immunoglobulin (IVIG) is widely used in treatment of a number of immune-mediated neurological diseases, the consensus on its optimal use is insufficient. To define the evidence-based optimal use of IVIG in neurology, the recent papers of high relevance were reviewed and consensus recommendations are given according to EFNS guidance regulations. The efficacy of IVIG has been proven in Guillain-Barre syndrome (level A), chronic inflammatory demyelinating polyradiculoneuropathy (level A), multifocal mononeuropathy (level A), acute exacerbations of myasthenia gravis (MG) and short-term treatment of severe MG (level A recommendation), and some paraneoplastic neuropathies (level B). IVIG is recommended as a second-line treatment in combination with prednisone in dermatomyositis (level B) and treatment option in polymyositis (level C). IVIG should be considered as a second or third-line therapy in relapsing-remitting multiple sclerosis, if conventional immunomodulatory therapies are not tolerated (level B), and in relapses during pregnancy or post-partum period (good clinical practice point). IVIG seems to have a favourable effect also in paraneoplastic neurological diseases (level A), stiff-person syndrome (level A), some acute-demyelinating diseases and childhood refractory epilepsy (good practice point)
    Udgivelsesdato: 2008/9
    OriginalsprogEngelsk
    TidsskriftEuropean Journal of Neurology
    Vol/bind15
    Udgave nummer9
    Sider (fra-til)893-908
    Antal sider15
    ISSN1351-5101
    StatusUdgivet - 2008

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