THE EFFECT OF ACTH ON EMG IN MULTIPLE SCLEROSIS PATIENTS

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Abstract
Increased endogenous ACTH/[adenocortico-tropic]/corticosteroid production can induce an electromyographic and histologic myopathy picture (Muller and Kugelberg 1959). The same effect by synthetic corticosteroids was demonstrated by several workers. In conjunction with ACTH treatment of multiple sclerosis patients we therefore made an EMG [electromyogram] study in 12 cases, of which eight received high dosage ACTH therapy and four low dosage. The EMG was recorded from the M. biceps brachii during ACTH treatment and also after a treatment free interval. In both treatment groups the muscle potential durations were significantly shortened during ACTH treatment. The potential durations of the MS [multiple sclerosis] groups on or off treatment, do not differ significantly from a healthy control group of 27 subjects. A biopsy specimen from the M. biceps brachii in four cases during high dosage ACTH treatment showed a normal picture with routine histological technique. One of the cases improved considerably, one moderately, four somewhat, while 5 remained unchanged and one grew somewhat worse. One case of diabetes, one case of gastric ulcer and psychosis, one case of psychosis and 5 of moderate hypo-kaliemia occurred. In the absence of histological changes the question of whether a true myopathy can be induced by ACTH treatment has to be left open pending further investigations.

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