Intravenous Immunoglobulins in Neurological Diseases: Established and Novel Clinical Applications

Over the last decade, high-dose polyclonal intravenous immunoglobulin (IVIg) is used increasingly in the management of autoimmune conditions of the central and peripheral nervous system. Despite the expanded use of IVIg, the consensus on its optimal use is insufficient. Currently chronic idiopathic demyelinating polyneuropathy (CIDP), Guillain – Barre syndrome (GBS) and multifocal motor neuropathy (MMN) are the three major immune neuropathies, in which the latest evidence strongly supports the use of IVIg as a first-line therapy. In addition to these disorders, there is a rising number of other neurological indications in which IVIg has been used as a therapy, even though the available evidence-based data are relatively sparse and less convincing. Due to increasing costs of this treatment and relative shortage of products, careful selection of patients who will benefit from IVIg is extremely important (Elovaara & Hietaharju, 2010). In this paper the current literature on the use of IVIG in treatment of neurological diseases has been reviewed and evidence-based recommendations, as well as less convincing data and future possibilities for its use in these disorders are presented.