Marieke van Rosmalen

Clinical outcomes in MMN 31 2 compared to patients with shorter disease duration (all p < 0.05) ( Figure 2.3 and Supplemental table 2.2 ). We found abnormal vibration sense on the toes in 57 patients (57.6%). Median disease duration was longer in these patients compared to those without sensory findings (median 16.1 years, range 1.3 – 46.5 vs. median 11.5 years, range 1.9 – 30.5; p = 0.03). We found at least one absent reflex in 79 patients (79%). Sixteen of these patients (20%) had generalized areflexia ( Supplemental table 2.3 ). We did not find a relation between the presence of conduction block (definite and/or probable) and the absence of reflexes ( p > 0.10). Figure 2.2 Clinical characteristics over time Median age at onset of symptoms and median age of diagnosis over time. Error bars are 95% confidence intervals. Nerve conduction studies and laboratory investigations One or more definite CBs were present in 74 patients (74.0%), only probable CB in 19 patients (19.0%) and no CB in 7 patients (7.0%). The diagnosis of MMN in these 7 patients without CB was based on the presence of anti-GM1 IgM antibody titers (4 patients; 57.1%), abnormal CSF protein concentrations (protein level > 0.4 gram/litre (g/L); 2 patients; 28.6%), an abnormal MRI of the brachial plexus (3 patients; 42.9%), and response to immunoglobulin therapy in all patients. We found evidence of axonal damage during NCS in 71 patients (71.0%), the presence of anti-GM1 IgM antibodies in 55/90 patients (61.1%) and abnormal CSF protein concentrations (>0.4 g/L) in 20/26 (76.9%) patients.