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,