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Karl Wessel, MD; Karsten Langenberger; Matthias F. Nitschke, MD; Detlef Kömpf, MD

Arch Neurol. 1997;54(4):397-400.

Abstract
Objective
To determine whether treatment with physostigmine can improve the conditions of patients with ataxia.

Design
A double-blind crossover study with physostigmine was performed in 19 patients with degenerative cerebellar diseases.

Setting
Patients were selected from an ongoing prospective follow-up study at the university hospital in Lübeck, Germany.

Patients
Eleven patients with autosomal dominant cerebellar ataxia and 8 patients with idiopathic cerebellar ataxia.

Intervention
Physostigmine was administered by using a transdermal system (patch) containing 30 mg of physostigmine as a base, of which about 6 mg is released during 24 hours along a diffusion gradient. Each treatment phase with the physostigmine patch or the placebo lasted 4 weeks, after which the treatment of patients was crossed over to the other phase.

Main Outcome Measures
Ataxia was documented and quantified by using a clinical score and posturographic measures.

Results
Physostigmine patches had no significant effect on cerebellar symptoms.

Conclusion
Treatment with physostigmine does not improve the conditions of patients with ataxia.

Author Affiliations
From the Department of Neurology, Medical University of Lübeck, Lübeck, Germany.

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