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Dewey A. Nelson, MD
48 Omega Dr Newark, DE 19713

Arch Neurol. 1991;48(3):259.

	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.

—There have been numerous warnings in various medical journals concerning the therapeutic use of methylprednisolone acetate (Depo-Medrol, Upjohn, Kalamazoo, Mich) by intraspinal injection.^1-19 Goldstein et al¹ were the first to publish complications in 1970. There followed reports of additional complications by Nelson et al,^2-6 Bernat et al,⁷ Nelson,^8-10 Roche,¹¹ Sekel,¹² Kepes and Duncalf,¹³ and Nelson.^14-19 Bernat et al⁷ demonstrated how this steroid compound entered the subdural space, then formed a "second sac," following which it migrated intracranially. Though the intrathecal use of methylprednisolone acetate virtually terminated by 1980,¹⁴ the epidural use by anesthesiologists in pain clinics gave rise to even more controversy than did its intrathecal therapy.^11-19 Two studies from Australia described 82% to 100% roentgenographically proved arachnoiditis (even from single injections) that resulted from intrathecal use,¹¹ as well as sterile meningitis, pachymeningitis with . . . [Full Text PDF of this Article]

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