Though the mechanisms of action of
intravenous immunoglobulins (
IVIG) are not completely understood, these drugs are widely used in treatment of
autoimmune diseases. In this review, we have analyzed the literature on the use of
IVIG in the treatment of
autoimmune diseases of the nervous system in children and discuss the management of patients basing on the recommendation of the European Federation of Neurological Societies. The efficacy of
IVIG in children has been shown as first line treatment in
Guillain-Barre syndrome, chronic inflammatory demyelinating
polyneuropathy, multifocal motor neuropathy,
dermatomyositis as a second-line
drug in the combination with
prednisolone or immunosuppressors in patients refractory to treatment with
corticosteroids and
cytostatics, myasthenic crisis in
myasthenia gravis, exacerbations and short-term treatment of severe forms, non-responsiveness to
acetylcholinesterase inhibitors,
multiple sclerosis as second or third line of treatment in patients with relapsing-remitting course with intolerance to standard
immunomodulatory therapy, acute multiple
encephalomyelitis with no response to the treatment with high doses of
corticosteroids,
paraneoplastic syndromes, pharmacoresistant
epilepsy and
autoimmune encephalitis. Because the right choice of the
drug plays a key role, in particular, in children, that determines the efficacy and safety of the treatment, we present the main approaches to the choice of the
drug and schemes of treatment of
autoimmune diseases of the nervous system in children.