No abstract

A randomized controlled trial of exchange versus no exchange was conducted to find out whether plasma exchange would be useful in acute inflammatory polyradiculoneuropathy. It was calculated that 15 patients would be required in each group to demonstrate a worthwhile improvement in functional ability one month after completion of treatment. Treatment comprised five exchanges in 10 days (55 ml plasma/kg body weight/exchange). Both groups received normal supportive care and were followed up periodically for a year. Overall the treated group showed a slight but not significant benefit (p>0.05); at two weeks' follow‐up of patients admitted to the trial within 14 days of onset of neuropathic symptoms, p=0.07. These results do not provide grounds for recommending plasma exchange for the treatment of severe AIP.

Glaser (1973) pointed out that a reversible encephalopathy may occur in some patients treated with large doses of the drug. We describe two patients in whom choreo-athetoid involuntary movements were a prominent and presenting feature and in whom the involuntary movements and the encephalopathy were closely correlated with very high blood phenytoin concentrations.