Doctor Discussion Guide

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Starting a conversation

Multifocal Motor Neuropathy (MMN) is a long-lasting disease that causes muscle weakness in the hands and/or feet, usually on one side of the body.

Whether it’s time to talk about a potential diagnosis, starting treatment, or how managing MMN can fit into your daily routine, the conversation you have with your doctor is key.

Build your doctor discussion guide

Your doctor will only know how you’re doing if you tell them. Get the most out of your conversation by answering the following questions in this interactive questionnaire. Your answers will be used to build a discussion guide you can download to print or save. That way you'll have all of your important information in one place to bring to your next doctor's appointment. Please note, the discussion guide is not intended to diagnose your condition or provide medical advice.

What best describes you?

000.

Are you experiencing muscle weakness in your hands and/or feet?

This might include things like difficulty gripping objects, trouble extending your wrist (wrist drop), difficulty lifting the front part of your foot (foot drop).

101.

Do you experience muscle spasms, cramps, and/or twitching in your hands and/or feet?

102.

Have you noticed any trouble with your hands and/or feet that is worse on one side of your body, or "asymmetrical"?

103.

What parts of your body are giving you trouble?

Check all that apply

104.

Does one side of your body give you more trouble than the other?

105.

Are you experiencing any numbness, tingling, or pain?

106.

Have you experienced any issues with your sense of touch?

107.

Have you noticed muscle weakness that gets worse in cold temperatures?

108.

How long have you been having trouble with your hands and/or feet?

109.

Have you noticed that your symptoms are getting worse over time?

110.

When were you diagnosed with MMN?

201.

Have you ever received treatment for MMN?

202. Have you ever received treatment for MMN?

Do you have any problems with your hands or arms?

203.

Do you have difficulty doing any of the following?

Select all that apply

204.

Are you able to do all of your zips and buttons without help?

205.

Are you able to tie a bow in laces or strings without help?

206.

Are you able to wash and brush your hair without help?

207.

Are you able to feed yourself without help?

208.

Please rate the severity of the trouble you're having with your hands or arms.

209.

Are you experiencing muscle weakness in your feet and/or legs?

210.

Do you have difficulty doing any of the following?

211.

Please rate the severity of the trouble you're having with your feet and/or legs.

212.

How often does trouble with your feet and/or legs get in the way of your daily routine?

213.

Have you noticed any worsening or other changes in your MMN symptoms recently?

214.

If you're interested in discussing treatment with your doctor, what topics are important to you?

Select all that apply

215.

Is there any other important information you would like to discuss with your doctor about your MMN?

When were you diagnosed with MMN?

301.

When did you start treatment for MMN?

302.

What are important considerations about your treatment plan that you would like to discuss with your doctor?

Select all that apply

303.

Where would you prefer to receive your treatment?

304.

Have you noticed any worsening or other changes in your MMN symptoms recently?

305.

Have you noticed your symptoms are managed after treatment, but start worsening again before your next treatment?

306.

Please rate the severity of the trouble you're currently having with MMN symptoms.

307.

How often does trouble with your hands or feet get in the way of your daily routine?

308.

Specifically, does trouble with grip strength get in the way of your daily activities?

309.

Do you have to rely on help from others because of your MMN symptoms?

310.

Get your discussion guide

Your responses have been collected to create an informative Doctor Discussion Guide designed to help you talk with your doctor about your personal experience. Bring it to your next doctor’s appointment to start a conversation.

Please note, Takeda will not retain information you provide to create this discussion guide.

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