Letter of Medical Necessity for IVIG

OMS is an autoimmune paraneoplastic syndrome. It causes body jerks and abnormal eye movements, ataxia, low muscle tone, learning and behavior problems, and speech impairment. The only effective treatments for OMS are immunotherapies.

IVIG is now part of the standard treatment of pediatric opsoclonus-myoclonus. As in other neurological disorders, it is used for immunomodulation, not to replace immunodeficiency. There are now several reports of efficacy. Immunomodulation helps reduce brain inflammation, which is the cause of neurological problems. An infusion of IVIG is necessary in a timely fashion to prevent neurological deterioration.

For more information on IVIG, refer to www.omsusa.org

The following is a list of IVIG references:

Yaman, D., et al. Brain SPECT imaging and treatment with IVIg in acute post-infectious cerebellar ataxia: Case report. Neurological Research, vol.20, Jan., pp. 85-88, 1998

Dalakas, MC. Intravenous immune globulin therapy for neurologic diseases. Annals of Internal Medicine, 126: 721-730, 1997

Pranzatelli, MR. The Immunopharmacology of the Opsoclonus-Myoclonus Syndrome. Clinial Neuropharmacology, vol. 19, No. 1, PP. 1-47, 1996

Counsell, CE., et al. Reversal of subacute paraneoplastic cerebellar syndrome with intravenous immunoglobulin. Neurology, 44:1184-1185, 1994

Vega, F., et al. Intravenous immunoglobulin therapy in paraneoplastic neurologic syndromes (pns) with antineuronal antibodies. Neurology, 44:157, 1994 (suppl 2)

Recht, L. Early diagnosis and intravenous globulin therapy in paraneoplastic cerebellar degeneration. Journal of Neurology Neurosurgery and Psychiatry. 56:1338, 1993 (letter)

Edmondson, JC., et al. Use of intravenous gamma globulin therapy for postinfectious acute cerebellar ataxia/opsoclonus of childhood. Annals of Neurology, 32:440, 1992 (abstr)

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