Immune checkpoint inhibitors (ICIs) have significantly improved the clinical outcome in multiple types of advanced or metastatic malignancies and are prescribed increasingly. However, immune-related adverse events (irAEs) occur frequently. Here, we present a patient with multifocal motor neuropathy and melanoma, with worsening of muscle weakness upon ICI therapy and concomitant use of steroids for the treatment of hepatitis, which was considered an irAE. Upon treatment with highly dosed immunoglobulins and steroid tapering, the patients' muscular symptoms improved while hepatitis resolved. This case highlights the importance of careful evaluation of patients with multifocal motor neuropathy treated with ICIs, highlights the risks of treatment with steroids in multifocal motor neuropathy patients and suggests an alternative treatment of irAEs with intravenous immunoglobulins.
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http://dx.doi.org/10.1080/1750743X.2024.2342238 | DOI Listing |
Brain Nerve
January 2025
Department of Neurology, Graduate School of Medicine, Chiba University.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) includes a number of clinical subtypes. The major phenotype is "typical CIDP," which is characterized by symmetric and "proximal and distal" muscle weakness. Due to historical changes in the concept of CIDP, multifocal motor neuropathy, anti-myelin-associated glycoprotein (anti-MAG) neuropathy, and autoimmune nodopathy were excluded.
View Article and Find Full Text PDFJ Neuroeng Rehabil
December 2024
Department of Neurology, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074, Aachen, Germany.
Background: Chronic immune-mediated neuropathies are clinically heterogeneous and require regular, objective, and multidimensional monitoring to individualize treatment. However, established outcome measures are insufficient regarding measurement quality criteria (e.g.
View Article and Find Full Text PDFVet Pathol
December 2024
Cornell University, Ithaca, NY.
Progressive neurologic signs without a known underlying etiology have been observed in managed gibbon populations housed at institutions in North America. In 2018, the Gibbon Species Survival Plan initiated a veterinary survey to evaluate clinical histories among gibbons displaying neurologic signs. The clinical results of this survey as well as the results of a centralized histologic review of brain samples from 5 species of managed gibbons displaying neurologic signs are outlined here.
View Article and Find Full Text PDFNeurology
January 2025
From the Department of Medicine (L.P., V.B., M.C.F.S., R.F.), Pathology and Laboratory Medicine (J.P.M.), Division of Neurosurgery (B.D.), and Department of Radiology (INR and DNR) (B.D., R.F.), The Ottawa Hospital Research Institute, Ottawa, Ontario, Canada.
We present the case of a 70-year-old man with a history of embolic stroke, atrial fibrillation, deep vein thrombosis, and polymyalgia rheumatica who presented as a stroke code with transient right-sided focal neurologic deficits (motor and sensory), mild alteration in consciousness, and mild aphasia. His cerebrovascular imaging revealed new multifocal intracranial stenoses. Despite best medical management, this patient continued to have recurrent symptomatic cerebrovascular events.
View Article and Find Full Text PDFCureus
November 2024
Neurology, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, IND.
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