Creatine Metabolism in Paralyses Due to Various Causes, Especially Injuries to the Spinal Cord

Abstract

CREATINE intolerance is characteristic of the various types of muscular dystrophies.* However, it has been described in many other conditions. Among the neurological diseases it has been noted chiefly in progressive muscular atrophy \ s =d \ and anterior poliomyelitis.\s=dd\ Of great importance is its occurrence both in acute anterior poliomyelitis and in the severe residuals. It has been reported in many non-neurological disorders but from few observations, as in immobilization 11 and amputation.12Among the patients with injuries to the spinal cord were many with disturbances in metabolism of heat, water, sugar, etc. As a part of the studies of disturbances in metabolism there was included one on creatine tolerance.The clinical material consisted of 14 patients with severe hemiplegia and 3 with crural paraplegia of cerebral origin, 9 patients who had been submitted to an anterior rhizotomy, and 6 patients with severe residuals of anterior poliomyelitis. This portion of the material was used to compare creatine metabolism in cases of paralysis due to upper motor neurone lesions with that in cases due to lower motor neurone lesions. The conclusions drawn from this study contributed to our deductions relat¬ ing to injuries to the spinal cord at various levels. Of these there were 9 patients with injuries to the cervical spinal cord, 17 patients with uncomplicated injuries to the midthoracic and upper thoracic spinal cord, and 11 patients with injuries to the lower thoracic and lumbar portions of the spinal cord, both complicated by injury to the cauda equina. In all it was our opinion that the injury produced a complete physiological interruption of function, and in some an anatomical section was present.