What is it?

Multifocal motor neuropathy is a progressive muscle disorder characterized by weakness in the hands, with differences from one side of the body to the other in the specific muscles involved. It affects men much more than women.

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Signs & symptoms

If you have MMN, you’ll most likely notice the first symptoms in your hands and lower arms. Your muscles may feel weak and cramp up or twitch in a way you can’t control. It may start in specific parts of the arm or hand, like the wrist or finger. Usually the symptoms are more severe on one side of your body. The disease may eventually affect your legs.
MMN isn’t painful, and you’ll still be able to feel with your hands and arms because your sensory nerves are not affected. But your symptoms will slowly get worse as you get older.


Doctors often mistake MMN for amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. They have similar symptoms, like twitching. Unlike ALS, though, MMN is treatable.
Your doctor may tell you to see a neurologist, a specialist who treats problems with the nervous system. They will give you a physical exam and also ask questions about your symptoms
The doctor will do some nerve and blood tests to rule out other conditions that might cause your symptoms. They may do:
* A nerve conduction study (NCS). This test measures how fast electrical signals travel through your nerves. Usually your doctor will put two sensors on the skin over one of your nerves: one to transmit a small electric shock and the other to record the activity. The doctor will repeat the test on other nerves if they think that more than one is involved.
* A needle electromyography (EMG). Your doctor will put electrodes on your arms. The electrodes have small needles, which go into your muscle, and they’re attached by wires to a machine that can measure the electrical activity in your muscles. Your doctor will ask you to slowly flex and relax your arms so the machine can record the activity. The doctor can do this test at the same time as the NCS.
* A blood test to look for GM1 antibodies, part of your body’s immune system. Some people with MMN have higher levels of them. If you do have a lot of these antibodies, chances are you have the disease. You might have MNN even if you don't have a lot of the antibodies, though.


If symptoms are very mild, you may not need any treatment. If you do need treatment, the doctor will probably prescribe a medication called intravenous immunoglobulin (IVIg). You’ll get the drug directly into one of your veins through an IV. You’ll usually get it in a doctor's office, although you can learn to do it at home.
If IVIg works, you should feel your muscle strength improve within 3 to 6 weeks. The effects will wear off over time, though, so you’ll need to keep having the treatment. People usually have it once a month, but it may be more or less often depending on your condition.
IVIg doesn't have many side effects, but it is expensive.
Doctors are testing ways to give it directly through the skin like a regular shot, but this method isn’t available for everyone.
If IVIg doesn't work, your doctor may try a drug called cyclophosphamide (Cytoxan), which is also used to treat certain types of cancer. This drug controls symptoms by turning down your immune system. Unlike immunoglobulin, cyclophosphamide can have bad side effects, so doctors try not to use it.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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