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Multifocal Motor Neuropathy – Treatment — SCE Neurology MCQ

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HardPeripheral Neuropathy & NeuromuscularMultifocal Motor Neuropathy – TreatmentSCE Neurology

A 55-year-old man presents with progressive lower limb weakness without sensory symptoms. He has no fasciculations. NCS show conduction block in the common peroneal nerve at a non-entrapment site and in the ulnar nerve at the forearm. Sensory studies are entirely normal. Anti-GM1 IgM antibodies are positive. What is the recommended first-line treatment?

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Correct answer: E — Intravenous immunoglobulin

The best answer is “Intravenous immunoglobulin”. Neuromuscular diagnosis combines distribution, reflexes, sensation, electrophysiology, laboratory, antibody, imaging and genetic findings; testing should resolve a live diagnostic or treatment decision rather than repeat established evidence. The alternatives “Oral prednisolone”, “Plasma exchange”, “Rituximab”, “Cyclophosphamide” are clinically adjacent possibilities, but they do not match the defining chronology, localisation, physiology, investigation result or UK management sequence in this stem.

Reference: JNNP specialist neuromuscular literature: https://jnnp.bmj.com/