Diagnosis:
This is diagnosed by a combination of clinical features, NCS/EMG and antibodies
Clinical features:
Distal symmetric, sensorimotor (sensory> motor),
Findings on investigations:
Anti-MAG: positive, IgM against myelin associated glycoprotein MAG
SPEP +IFE: IgM paraprotein, monoclonal
NCS/EMG:
- Distal slowing
Pathology/nerve biopsy:
Demyelination, axonal degeneration
IgM deposits at sites of MAG localisation
Immunohistochemsitry:
- Immunofluorescence with Anti-immunoglobulin
Treatment:
Intravenous immunoglobulin IVIG, plasmapharesis
Cyclophosphamide
Related articles:
- Approach to weakness, neuromuscular disease patterns, polyneuropathy,
- Polyneuropathy associated with paraproteinemia,