Anti-ganglioside Complex IgM Antibodies in Multifocal Motor Neuropathy Post-influenza Vaccination

Multifocal motor neuropathy (MMN) is a peripheral nerve disorder characterized by progressive, predominantly distal, asymmetric limb weakness with minimal or no sensory impairment, and characterized by the presence of antibodies (30-80% cases), mostly IgM, to the gangliosides, mainly ganglioside monosialic acid (GM1). We describe a case of MMN in a patient who developed symptoms of paresthesia and extremity weakness a few days after receiving the influenza vaccine and was found to have high titers of anti-GM1 IgM antibody levels. He was initially treated with intravenous immune globulin (IVIG) which is one of the mainstays of treatment but relapsed and was then successfully treated with plasma exchange.