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Poly ICLC in the Treatment of Postinfectious Demyelinating Encephalomyelitis
Andres M. Salazar, MD;
W. King Engel, MD;
Hilton B. Levy, PhD
Arch Neurol. 1981;38(6):382-383.
Abstract
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• Three weeks after a mild and presumably infectious illness, a 21-year-old man developed a CNS disorder characterized by involvement of the cerebellum, cerebrum, and brainstem. It progressed, sometimes stepwise, without remission, over five months to being bedfast with total spastic paraplegia, severe ataxia, and unintelligible dysarthric speech. The CSF showed increased levels of protein, IgG, and myelin basic protein, as well as five oligoclonal bands. Because of failure of the patient's condition to respond to prolonged prednisone therapy, poly ICLC was given intravenously weekly for 20 weeks (median dose, 100 µg/kg). Improvement, evident after the first dose, progressed to the point of ambulation with some assistance. Even though the relation of the patient's marked recovery to poly ICLC therapy remains unproved, this experience provides reason for considering a possible therapeutic role of the drug in postinfectious demyelinating encephalomyelitis and perhaps in multiple sclerosis.
Author Affiliations
From the Central Nervous System Studies Laboratory (Dr Salazar) and the Neuromuscular Disease Section (Dr Engel), National Institute of Neurological and Communicative Diseases and Stroke, and the National Institute of Allergy and Infectious Diseases (Dr Levy), National Institutes of Health, Bethesda, Md.
Footnotes
Accepted for publication Aug 7, 1980.
Reprint requests to Neuromuscular Diseases Section, National Institute of Neurological and Communicative Disorders and Stroke, Bldg 10, Room 10D20, Bethesda, MD 20205 (Dr Engel). As of July 1981, Dr Engel will be with the Department of Neurology, University of Southern California School of Medicine, 2025 N Zonal Ave, Los Angeles, CA 90033.
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