Double-Blind Controlled Trial of Immunosuppression in the Treatment of Multiple Sclerosis: Final Report

The current therapy of multiple sclerosis

“…These studies again lacked the power of randomized control analysis. Subsequent randomized, double-masked, controlled trials showed beneficial, but non-significant, trends favouring prolonged azathioprine treatment (20)(21)(22). This experience was repeated in one of the largest, double-blind, control trials of azathioprine in MS to date.…”

“…Data from early uncontrolled studies of this alkylating agent suggest asimilarmodest benefit. Inonestudy, 21 patients with chronicprogressiveMS were treated with low-dose cyclophosphamide and only one had worsened, using standard clinical scoring, 1 year later compared with 14 out of 24 worsening after corticosteroid therapy (26). Morerecently, the interim results fromaNorth American multicentre trial of intravenous cyclophosphamidel ACTH, with or without 2-monthly cyclophosphamide maintenance boosters, in a 5-year, randomized, singleblind study showed a positive effect on the rate of disease progression in favour of booster therapy (27).…”

74 year old lady who developed bilateral parkinsonism secondary to an intrinsic cerebral tumour.

“…Oxford, UK Meanwhile, it would seem prudent, whenever possible, to perform correlative histol-References ogy and biochemistry on material taken I Arendt T, Bigl V, Tennstedt 2 years had complained of vague headaches. During this time she also complained of dizziness for which prochlorperazine was prescribed.…”

Computed tomographic findings of brain and skull in myotonic dystrophy.

“…inated encephalomyelitis: (1) there was no His CT scan showed mild frontal atrophy. history of antecedent infection or Three months later, his palatal myoclonus vaccination;' (2) systemic symptoms (fever, had remitted. Various manoeuvres including headache, nausea) which are included in all breath holding, squeezing the hands, curling descriptions of acute disseminated encephathe toes, moving joints and hyperventilation lomyelitis, were absent.2 Our patient was in are known to exacerbate palatal myoclonus.…”

“…in differential diagnosis,2 Reik L. Disorders that mimic CNS infections. compounded by the still not widely known In: Neurologic Clinics; Philadelphia: WB fact that all the ancillary supporting data, Saunders Comp.…”