Effect of sulfamethoxazole and trimethoprim on neurologic dysfunction in a patient with Joseph's disease
K. A. Mello and B. P. Abbott
Department of Medicine, St. Luke's Hospital, New Bedford, Mass.
Joseph's disease, an autosomal dominant, degenerative neurologic disease
found in the Portuguese, is clinically manifested by extrapyramidal,
pyramidal, and cerebellar dysfunction. A patient with the type II form of
the disease reported improvement in gait and lessened spasticity while
taking sulfamethoxazole and trimethoprim (Bactrim) for a noninfectious
dysuria syndrome. A double-blind, placebo-controlled trial of Bactrim
utilizing a subjective performance scale, physical examination, and six
timed tests was performed in this patient. Results revealed lessened
spasticity, improvement in walker-assisted gait, and correlative subjective
responses. These results suggest an antispasticity effect of Bactrim or one
of its components in this patient.