Management of Acute Episodes in Multiple Sclerosis

Abstract

showed that some of the symptoms of multiple sclerosis could be reduced or abolished promptly with vasodilating drugs. Constrictions seen in retinal arterioles often appeared to be associated with scotomas; both constrictions and scotomas were affected by the drugs. From these and certain related observations the theory was evolved that at least some of the lesions are the consequence of vasospasm,3 with or without associated thrombosis (Putnam and others4). Photographs of constrictions will appear in another communication.5Franklin and I were unable at that time to apply these findings in such a way as to make them of definite therapeutic use. Others have since made efforts to do so. Previous efforts had been made to use vasodilation therapeutically, for other reasons. However, even though some of the results have been encouraging, the authors have not been satisfied that the problem of spontaneous remissions was fully controlled.Recently I have renewed vasodilation studies. My aim has been to learn whether the employment of certain standards of evaluation might not make the problem of spontaneous remissions less difficult to deal with and show more definitely whether vasodilating drugs (or any other rapidly acting drug it is desired to test) can be effectively used in the treatment of new symptoms.

On the Historical Succession of Vessel-Based Therapies in the Treatment of Multiple Sclerosis

“…These substances included amyl nitrite, carbon dioxide, histamine diphosphate and hydergine, and all possessed the capacity to increase cerebral perfusion [47,48,49,50,51,52,53]. Brickner's preliminary findings were confirmed by others [54,55,56], while the phenomenon became termed pharmacological reduction of abnormality (PRA) within minutes.…”

On the Historical Succession of Vessel-Based Therapies in the Treatment of Multiple Sclerosis

“…These substances included amyl nitrite, carbon dioxide, histamine diphosphate and hydergine, and all possessed the capacity to increase cerebral perfusion [47,48,49,50,51,52,53]. Brickner's preliminary findings were confirmed by others [54,55,56], while the phenomenon became termed pharmacological reduction of abnormality (PRA) within minutes.…”

On the Historical Succession of Vessel-Based Therapies in the Treatment of Multiple Sclerosis

“…These substances included amyl nitrite, carbon dioxide, histamine diphosphate and hydergine, and all possessed the capacity to increase cerebral perfusion [47,48,49,50,51,52,53]. Brickner's preliminary findings were confirmed by others [54,55,56], while the phenomenon became termed pharmacological reduction of abnormality (PRA) within minutes.…”

On the Historical Succession of Vessel-Based Therapies in the Treatment of Multiple Sclerosis

“…These substances included amyl nitrite, carbon dioxide, histamine diphosphate and hydergine, and all possessed the capacity to increase cerebral perfusion [47,48,49,50,51,52,53]. Brickner's preliminary findings were confirmed by others [54,55,56], while the phenomenon became termed pharmacological reduction of abnormality (PRA) within minutes.…”