Abstract Details

Title Pain in Multifocal Motor Neuropathy

Topic Peripheral Nerve

Presentation(s) P01 - (-)

Poster/Presentation
Number 146

Objective

Background BACKGROUND: Multifocal motor neuropathy is rare disorder characterized as painless persistent limb weakness. Focal limb weakness is common in MMN but has also been reported less commonly in CIDP. Both conditions are believed to be caused by an autoimmune process and respond to immune suppression or modulation. Chronic pain has been described in CIDP but not MMN. The signature of both conditions is abnormalities in nerve conduction studies. Slowing of motor conduction velocities and conduction block may be seen in both these conditions, while additional changes in sensory responses are seen in CIDP.

Design/Methods DESIGN/METHODS: Retrospective review of case histories. We retrospectively identified patients who presented to our institution with multifocal weakness from 09/2009 to 09-2012 to identify those patients with MMN. Of the patients with MMN we selected those who reported chronic pain as a prominent symptom. We then summarized the neuropathological, electrophysiolocal findings of these patients.

Results RESULTS: We identified 27 patients with treatment responsive MMN. 7 had pain as a prominent symptom. Average age was 54. There were 3 males. 3 had conduction block. All had abnormal motor conduction consistent with MMN. None had abnormal sensory conduction studies. Pathology of all showed evidence of neuropathy consistent with MMN. All 7 responded to IVIG.

Conclusions CONCLUSIONS: Multifocal neuropathy has previously been thought of as a painless neuropathy. We identified 7 out of 27 (26%) patients with pain. All 7 had clinical, electrodiagnositic and neuropathological evidence of MMN making the diagnosis certain. We surmise based on our findings that chronic pain is uncommon but not rare symptom in MMN, which readily responds to treatment with IVIG.

Authors/Disclosures
Eghosa Omoregie, MD PRESENTER	No disclosure on file
Ayushi Chugh, MD, FAAN	Dr. Chugh has nothing to disclose.
Dale J. Lange, MD, FAAN (Lange Neurology, PC)	No disclosure on file
Krzysztof W. Selmaj (University of Warmia and Mazury)	Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Biogen. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Novartis. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BMS. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Astra. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for BMS. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Astra. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Biogen. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Novartis. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for BMS. Krzysztof W. Selmaj has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Merck.

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