EFFECTS OF CORTISONE AND ACTH IN MUMPS MENINGO-ENCEPHALITIS

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Abstract
The efficacy and safety of cortisone in the symptomatic treatment of 4 patients with severe or moderately severe mumps meningo-encephalitis have been investigated. A fifth patient was treated with ACTH (corticotropin). Diagnoses were made on clinical grounds. Confirmation of diagnoses was obtained in all cases by lumbar puncture and complement fixation titers were determined in four. The course of illness in the treated cases was evaluated by comparing them with cases reported in the literature, none of which received cortisone or ACTH. They were also compared with untreated cases, all of which were less severe, which came under the author''s observation during the period of the study. Cortisone was administered 200 to 300 mg/day in divided doses, and ACTH 60 mg/day in divided doses. In all cases but one, drugs were discontinued by progressive decrements. Cortisone and ACTH appeared to produce rapid remission of headache, nausea, anorexia, vomiting, photophobia, lethargy, delirium and nuchal rigidity. Fever fell rapidly but tended to return to previous levels for short periods of time, accompanied by minor recurrence of other symptoms. Orchitis developed in one patient during cortisone therapy. This patient, and one other, suffered additional salivary gland involvement during therapy. Abrupt termination of therapy in one case after 3 doses of cortisone resulted in a dramatic recurrence of previous symptoms. The duration of mumps in these patients did not differ from that in patients not receiving cortisone or ACTH. No evidence of residual disease of the nervous system could be detected in any of the patients.

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