Neurology: Case of the Month

Test Yourself — Patient 26

Multifocal Motor Neuropathy

1. The safest and most effective treatment for multifocal motor neuropathy is:
   • [ A ] Intravenous IgG
   • [ B ] Intravenous cytoxan
   • [ C ] Oral prednisone
   • [ D ] Intravenous corticosteroids
   • [ E ] Plasma exchange
2. All of the following are TRUE statements about multifocal motor neuropathy, EXCEPT:
   • [ A ] The electrodiagnostic hallmark of MMN is conduction block in motor nerves.
   • [ B ] Patients typically demonstrate muscle atrophy and may have myokymia.
   • [ C ] In patients with MMN, weakness is always accompanied by atrophy unlike ALS.
   • [ D ] Reflexes may be normal at the onset of the disease.
   • [ E ] Anti-GM1 antibodies may, or may not, be elevated in patients with MMN.
3. Electrophysiologically, patients with MMN typically show all of the following, EXCEPT:
   • [ A ] Markedly delayed conduction velocities
   • [ B ] Conduction blocks
   • [ C ] Absent or delayed F waves
   • [ D ] Fibrillation potentials
4. Patients with which of the following may present with significant proximal muscle weakness?
   • [ A ] Guillain-Barre syndrome
   • [ B ] CIDP
   • [ C ] Myaesthenia gravis
   • [ D ] ALS
   • [ E ] All of the above
   • [ F ] None of the above
5. Which of the following statements regarding MMN is TRUE?
   • [ A ] Patients with MMN are generally elderly at the time of onset, and the progression is rapid.
   • [ B ] Anti-GM1 antibodies are responsible for the disease by causing an autoimmune attack on myelin.
   • [ C ] The clinical characteristics of MMN are indistinguishable from those of ALS.
   • [ D ] Minor sensory symptoms may be present.
   • [ E ] Treatment of choice is intravenous steroids.

 

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