Immunosuppressive Treatment of Motor Neuron Syndromes: Attempts to Distinguish a Treatable Disorder

Ersin Tan, D. Joanne Lynn, Anthony A. Amato, John T. Kissel, Kottil W. Rammohan, Zarife Sahenk, John R. Warmolts, Jerry R. Mendell, Carlayne E. Jackson, Richard J. Barohn

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Abstract

Objective: To determine if response to immunosuppressive treatment in motor neuron syndromes could be predicted on the basis of clinical features, anti-GM1 antibodies, or conduction block. Design: Prospective, uncontrolled, treatment trial using prednisone for 4 months followed by intravenous cyclophosphamide (3 g/m2) continued orally for 6 months. Setting: All patients were referred to university hospital medical centers. Patients: Sixty-five patients with motor neuron syndromes were treated with prednisone; 11 patients had elevated GM1 antibody titers, and 11 patients had conduction block. Forty-five patients received cyclophosphamide, eight of whom had elevated GM1 antibodies and 10 had conduction block. Results: One patient responded to prednisone, and five patients responded to cyclophosphamide treatment. Only patients with a lower motor neuron syndrome and conduction block improved with either treatment. Response to treatment did not correlate with GM1 antibodies. Conclusions: GM1 antibodies did not serve as a marker for improvement in patients with motor neuron syndrome treated with immunosuppressive drugs. Patients with amyotrophic lateral sclerosis failed to improve irrespective of laboratory findings.

Original languageEnglish (US)
Pages (from-to)194-200
Number of pages7
JournalArchives of neurology
Volume51
Issue number2
DOIs
StatePublished - Feb 1994
Externally publishedYes

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ASJC Scopus subject areas

  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

Tan, E., Lynn, D. J., Amato, A. A., Kissel, J. T., Rammohan, K. W., Sahenk, Z., Warmolts, J. R., Mendell, J. R., Jackson, C. E., & Barohn, R. J. (1994). Immunosuppressive Treatment of Motor Neuron Syndromes: Attempts to Distinguish a Treatable Disorder. Archives of neurology, 51(2), 194-200. https://doi.org/10.1001/archneur.1994.00540140104020