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Dewey A. Nelson, MD
Section of Neurology Wilmington Medical Center Wilmington, DE 19899

Arch Neurol. 1979;36(10):661-662.

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To the Editor.—

In his article on the conus medullaris syndrome (ARCHIVES 36:228-230, 1979), Maj Fred L. Cohen stated: "Few serious complications have been associated with the intrathecal administration of corticosteroids in the treatment of lumbar radiculopathy." The patient described received intrathecal methylprednisolone acetate (Depo-Medrol) before the onset of a conus medullaris syndrome. Myelography showed changes at L4-S1 that the author interpreted as being postsurgical. It was not stated how far cephalad the myelogram dye was carried (Figures showed filling from at least T9 to the caudal sac).

There are a number of articles that indicate that this steroid compound is unsafe for the treatment of lumbar radiculopathy, as well as of other diseases. Goldstein et al¹ first reported arachnoiditis from administration of methylprednisolone acetate in the treatment of multiple sclerosis. Nelson et al^2-5 later described eight patients who had serious arachnoiditis (several requiring operation) and sterile . . . [Full Text PDF of this Article]

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