MMN is a rare, treatable, but incurable disorder of the immune system which causes muscle weakness that worsens over time. MMN commonly begins in the finger, thumb, wrist or lower leg.3,4 It affects the strength in the lower parts of the arms and hands more than the legs, usually without affecting touch sensation.1 MMN usually causes weakness in one side of the body (asymmetrical).4

While the exact cause of MMN is unknown, one potential mechanism to thought to be that immune system abnormalities affect the protective layer (myelin sheath) around nerve cells that control muscle function. The protective layer normally allows messages to be sent properly and quickly throughout the nervous system. When the protective layer breaks down (a process called demyelination), nerve damage can occur. When nerve impulses are interrupted, muscle weakness can occur.4,5

MMN is a rare, often difficult to diagnose disorder. Some symptoms of MMN are similar to those of other types of peripheral nerve disorders.6 The diagnosis of MMN often is based on a physical exam, an evaluation of symptoms, an electromyography (EMG) test, nerve conduction study, laboratory tests, MRI, and medical history.4,6

Your healthcare provider may also request a blood test or order other tests to fully understand your health status.4,6

While the exact cause of MMN is unknown, one potential mechanism to thought to be that immune system abnormalities affect the protective layer around nerve cells that control muscle function. In a normal nerve, the protective layer (myelin sheath) allows messages to be sent properly and quickly throughout the nervous system (Figure 1). When the protective layer (myelin sheath) breaks down (a process called demyelination), nerve damage can occur (Figure 2). When nerve impulses are interrupted, muscle weakness can occur.4,5

Normal peripheral nerve illustration

Figure 1: Normal peripheral nerve

Damaged peripheral nerve illustration

Figure 2: Damaged peripheral nerve

What it is

  • Chronic, treatable, but incurable immune-mediated disorder that affects nerves and muscles2
  • Associated with muscle weakness affecting the hands, forearms, and lower legs that can interfere with daily living4,8
  • Rare, often difficult to diagnose condition characterized by slow progressive asymmetric (on one side of the body) distal limb weakness4

What it is not

  • Fatal6
  • Amyotrophic lateral sclerosis (ALS) or Lou Gehrig's disease4,6
  • A nerve compression condition, such as carpal tunnel sydrome2,6

GAMMAGARD LIQUID [Immune Globulin Infusion (Human)] 10% is made from human plasma that is donated by healthy people. GAMMAGARD LIQUID contains antibodies collected from these healthy people. The role of these antibodies and how the IgG in GAMMAGARD LIQUID works to treat MMN is not fully understood.1


  1. GAMMAGARD LIQUID [Immune Globulin Infusion (Human)] 10% [Prescribing Information]. Westlake Village, CA: Baxalta US Inc.
  2. Katirji B, Koontz D. Disorders of peripheral nerves. In: Daroff RB, Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice. 6th ed. Philadelphia, PA: Elsevier Saunders; 2012:1915-2015.
  3. Slee M, Selvan A, Donaghy M. Multifocal motor neuropathy: the diagnostic spectrum and response to treatment. Neurology. 2007;69(17):1680-1687.
  4. Vlam L, van der Pol WL, Cats EA, et al. Multifocal motor neuropathy: diagnosis, pathogenesis and treatment strategies. Nat Rev Neurol. 2012;8(1):48-58.
  5. Piepers S, Jansen MD, Cats EA, van Sorge NM, van den Berg LH, van der Pol WL. IVIg inhibits classical pathway activity and anti-GM1 IgM-mediated complement deposition in MMN. J Neuroimmunol. 2010;229(1-2):256-262.
  6. Meuth SG, Kleinschnitz C. Multifocal motor neuropathy: update on clinical characteristics, pathophysiological concepts and therapeutic options. Eur Neurol. 2010;63(4):193-204.
  7. Shy ME. Peripheral neuropathies. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 24th ed. Philadelphia, PA: Saunders Elsevier; 2011:2396-2409.
  8. Sharrack B, Hughes RA. The Guy's Neurological Disability Scale (GNDS): a new disability measure for multiple sclerosis. Mult Scler. 1999;5(4):223-233.


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Gammagard Liquid MyIgCoPayCard Program Terms and Conditions

This manufacturer's coupon program is not valid for prescriptions reimbursed, in whole or in part, by Medicaid, Medicare, Medigap, VA, DoD, TRICARE, or any other federal or state healthcare programs, including state pharmaceutical assistance programs, and where prohibited by the health insurance provider or by law

Shire's MyIgCoPayCard program provides a maximum total benefit of $5,000 for eligible out-of-pocket costs and expires 12 months from date of activation. Eligible costs include deductible, copayment, and co-insurance costs for eligible Shire IG (Immunoglobulin) products. Non-medication expenses, such as ancillary supplies or administration-related costs, are not eligible.

To be eligible, patients must: 1. be starting or receiving treatment with (and have current prescription for) an eligible Shire IG product with an ICD-10 for a diagnosis of Primary Immunodeficiency; and 2. have commercial insurance that covers medication costs for prescribed Shire IG product and allows for CoPay assistance; and 3. be two (2) years old or older.

Acceptance of this offer must be consistent with the terms of benefits provided by patient's health insurance provider.

Offer limited to one card per person and may not be combined with any other coupon, discount, prescription savings card, rebate, free trial, patient assistance, or other offer.

This program is only valid for residents of the United States.

Shire reserves the right to change or discontinue this program at any time without notice.

This is not health insurance.


Add to patient instructions:

If your insurance situation changes, it is your responsibility to notify MyIgSource's CoPay assistance program.

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SHIRE and the Shire Logo are registered trademarks of Shire Pharmaceutical Holdings Ireland Limited or its affiliates. Gammagard Liquid is a trademark or registered trademark of Baxalta Incorporated, a wholly owned, indirect subsidiary of Shire plc.

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Important Safety Information

What is the most important information that I should know about GAMMAGARD LIQUID?

GAMMAGARD LIQUID can cause the following serious reactions: severe allergic reactions causing difficulty in breathing or skin rashes; decreased kidney function or kidney failure; blood clots in the heart, brain, lungs or elsewhere in the body; severe headache, drowsiness, fever, painful eye movements, or nausea and vomiting; dark colored urine, swelling, fatigue, or difficulty breathing.