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Erich W. Streib, MD
Department of Neurology The University of Nebraska Medical Center 42nd and Dewey avenues Omaha, NE 68105

Arch Neurol. 1979;36(6):386.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Guanidine hydrochloride is of value in the treatment of the Lambert-Eaton syndrome¹ and botulism.² More recently, it was tried in the treatment of motor neuron disease.³

Untoward side effects are frequent and include the following: cholinergic reactions of the gastrointestional (GI) system, paresthesias, skin changes, petechiae, and, with high doses, nervousness, tremors, and ataxia^1,3,4 More serious are the occasional occurrences of bone marrow depression and aplastic anemia^3,4 and probably long-term renal impairment.^5,6 Lambert and Howard⁴ and Henriksson et al⁶ mention one patient with elevation of alkaline phosphatase level and other indicators of hepatic dysfunction, which reverted to a normal level after discontinuation of treatment with the drug. Norris et al³ have treated more than 200 patients with various doses of guanidine. Liver function abnormalities are not mentioned in their study. We describe a patient with the Lambert-Eaton syndrome . . . [Full Text PDF of this Article]

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