Multifocal motor neuropathy (MMN) is a rare neurological disorder characterized by progressive muscle weakness, primarily affecting the arms and legs. It affects your body's motor nerves, which control your muscles. MMN makes it hard for your motor nerves to send electrical signals that move your body. MMN is a rare, chronic disease that causes slowly worsening muscle weakness, mainly in your hands, arms, and legs. While living with MMN can be challenging, understanding the condition and adopting positive self-management strategies can significantly improve quality of life. It's a chronic condition that's not curable. But treatment is usually very effective, helping slow down the disease and improve your muscle function. It probably won't shorten your life. Early diagnosis and treatment, and following a healthy lifestyle, are keys to staying active and independent.
Understanding Multifocal Motor Neuropathy (MMN)
MMN is a rare disease that affects less than 1 in 100,000 people. The disorder affects less than one person per 100,000 people. Experts don't know exactly what causes MMN, but they know you're not born with it. It's an autoimmune disease, meaning your immune system mistakenly attacks your nerve cells as if they were invaders. Researchers are working to find out why it happens. MMN is thought to be caused by alterations in the immune system, such that certain proteins (antibodies) that would normally protect one from viruses and bacteria begin to attack constituents of peripheral nerves. Antibodies may be directed against “GM-1,” a ganglioside located at the Node of Ranvier. These antibodies have been detected in at least one third of MMN patients. More recent studies also suggest that newer tests for antibodies directed against GM-1 combined with a number of related gangliosides, are positive in over 80% of MMN patients.
Symptoms and Diagnosis
You may first notice symptoms in your hands and lower arms. They may feel weak, cramp up, or twitch in ways you can't control. Those symptoms may start in specific parts of your arm or hand, such as your wrist or finger. They're often more severe on one side of your body. MMN may eventually affect your legs. This condition isn't painful. You can feel with your hands and arms because your sensory nerves aren't affected. Your symptoms will likely get worse with age.
Doctors often mistake MMN for amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease. These conditions have similar symptoms. But unlike ALS, MMN is treatable. MMN and motor neuron disease (MND) can have similar symptoms. But the main difference is that MND affects groups of spinal nerves, while MNM affects single nerves. Both have similar symptoms, but ALS isn't treatable, while MMN is. Weakness in your hands and arms is a common first symptom.
You may need to see a neurologist, a medical doctor who specializes in problems with your brain and nervous system. They'll give you a physical exam and ask questions about your symptoms. They may ask:
Read also: Managing Stage 3 Kidney Disease with Diet
- Which muscles are giving you trouble?
- Is it worse on one side of your body?
- How long have you been feeling this way?
- Do you have numbness or tingling?
- Does anything make your symptoms better? What makes them worse?
They'll do nerve and blood tests to rule out other conditions. They may include:
Nerve conduction study (NCS). This test measures how fast electrical signals travel through your nerves. Usually, your doctor puts two sensors on the skin over one of your nerves: one to transmit a small electric shock and the other to record the activity. They repeat the test on other nerves if they think more than one is involved.
Needle electromyography (EMG). Your doctor will put electrodes on your arms. They have small needles that go into your muscle. They're attached by wires to a machine that measures electrical activity in your muscles. Your doctor will ask you to slowly flex and relax your arms so the machine can record the activity. They'll do this test at the same time as the NCS.
Blood test. This will look for GM1 antibodies, part of your body’s immune system. Some people with MMN have higher levels of them. If you have a lot of these antibodies, chances are you have MMN. You can still have it even if you don't have a lot of the antibodies.
Treatment and Management of MMN
A diagnosis of MMN can bring up many emotions, but there’s relief in knowing it’s treatable. ? Now’s the time to partner with your doctors (including a neurologist, most likely) and figure out what comes next.
Read also: Explore Diet and Disease
If your symptoms are very mild, you may not need any treatment. But if you do, your doctor may prescribe a medication called intravenous immunoglobulin (IVIG). It's given directly into one of your veins through an IV. You'll usually have this done in your doctor's office, but you can learn to do it at home. (IVIg) therapy. in your system. It’s delivered into your vein, usually in your arm, either at an infusion center or with an at-home infusion nurse.
If IVIG works, you should feel your muscle strength improve in three to six weeks. The effects wear off over time, so you need to keep having treatments. Most people with MMN have it once a month, but you may need it more or less often. IVIG doesn't have many side effects, but it's expensive.
Doctors are testing ways to give it like a regular shot, but this method isn't yet 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. It controls symptoms by slowing down your immune system. Unlike immunoglobulin, cyclophosphamide can have severe side effects, so doctors try not to use it.
Therapeutic massages, heat therapy, physical therapy, ultrasound, electrical stimulation, and trigger point injections may also help. Talk to your doctor about whether any of these could help you. Also, talk to your doctor about ongoing clinical trials to see if you're a candidate.
Your MMN management plan might change over time, depending on your symptoms and current needs. Have open and honest conversations with your healthcare team about your concerns if something isn't working. Keep your doctor up to date on your symptoms and how you feel while taking your medication. You and your doctor can develop a management plan that works for you. How can managing MMN help with my health goals?
Read also: A Review of the Mediterranean Diet in Kidney Disease
Positive Self-Management Strategies
While living with MMN can be challenging, there are several self-management techniques that can help improve your quality of life:
Stay active: Engage in low-impact exercises to maintain muscle strength and flexibility. You also may find it helpful to keep up a low-impact exercise routine, as you are able. This may include stretching your muscles on a regular basis. Work with your doctor to build an exercise regimen that feels effective to you. Consult with a physical therapist to develop a safe and effective exercise routine.
Adapt your environment: Use assistive devices and make modifications to your home and workplace to accommodate any physical limitations.
Manage fatigue: Balance activity with rest periods to avoid overexertion.
Dietary Recommendations for MMN
Although there’s no official diet recommended for MMN, a healthy lifestyle is good for overall well-being. Like other types of chronic disease, I strongly believe an individual's diet affects the management, and in certain situations, even the progression of a chronic GI disease," says Marta Jonson, MMN, RDN, LMNT, Nebraska Medicine nutrition therapist. Like other chronic diseases, GI patients often experience chronic inflammation, potentially leading to additional health problems. The way we eat may help prevent and keep chronic inflammation at bay. Diet becomes crucial in preventing disease progression for those with certain GI-related autoimmune disorders. Research is limited but rapidly growing. "The Frederick F. Paustian Inflammatory Bowel Disease Center is partnering with Nebraska Food for Health to further microbiome research," says Jonson.
A healthy diet may look different for everyone. "Nutrition and health are much more complex than just looking at the macronutrients in someone's diet," adds Jonson.
Foods that Promote Gut Health
Foods that promote gut health contain prebiotic fibers and potential anti-inflammatory properties. Ideally, half your plate should be plants, a quarter filled with healthy carbohydrates, and the last quarter a serving of protein. When increasing fiber in your diet, your body needs time to adjust. It's essential to add fiber-rich foods slowly and stay hydrated to reduce discomfort. You don't need to shop exclusively organic or purchase only fresh produce to add variety and nutrients to your diet. No-salt canned versions and frozen are just as nourishing and can be less expensive.
- Flax seeds: Rich in omega-3, fiber, and antioxidants. Try adding them to oats and smoothies.
- Turmeric: An antioxidant, fights inflammation, and promotes immunity.
- Ginger root: Reduces inflammation and can help calm nausea.
- Beans: Aid digestion, are high in fiber, and slow digestion to help you feel full.
- Oats: Full of soluble fiber that may help lower cholesterol, slow digestion to help you feel full longer, and aid in blood sugar control.
- Pumpkin: Full of fiber and vitamin K, supports bone health, and promotes a healthy gut.
Foods to Limit or Avoid
Beware of "sugar-free" or "calorie-free" foods. Often this means artificial sweeteners have replaced sugar. Saturated fats are inflammatory to the gut and in almost any product on the shelf, including beef, pork and ham.
The Digestive System and Diet
The digestive system is a full-body process. Even our brain gets involved with the gut and microbes, affecting everything from mood and metabolism to our immune systems. Our digestive tract is an intricate system with many working parts and starts with the moment food touches our mouth. Particular enzymes in our salvia kick off the digestive process. As food travels from the esophagus to our stomach, enzymes work with contracting muscles, mixing food with the enzymes. The small intestine is where our gut microbes start to do their job by breaking down fats, carbs and proteins. It also supports our immune health and absorbs vitamins and minerals.
The Importance of Emotional Well-being and Support
Living with a chronic medical condition may feel stressful some days. Ongoing stress can have a negative effect on health. That’s why taking care of your emotional well-being should be an essential part of living with MMN. Mindfulness-based techniques can help with processing emotions and reducing overall stress levels for patients and caregivers. Mindfulness exercises or speaking with a therapist are a few options to consider. Your doctor may have a referral for therapists who specialize in working with people who have chronic conditions. You may find it helpful to read others’ MMN stories in an online community or forum.You also may benefit from talking about your experiences in a support group.
Your loved ones likely want to support your MMN goals, but they might not know the best ways to go about it. , it’s important to have a support system.
Additional Resources
To learn more about multifocal motor neuropathy, visit the web sites of the Neuropathy Action Foundation, the Neuropathy Association, or the GBS-CIDP (Guillain-Barré syndrome-chronic inflammatory demyelinating polyneuropathy) Foundation International.
tags: #mmn #disease #diet #recommendations