THE MECHANISM INVOLVED IN POLYNEURITIS AS EXEMPLIFIED BY POSTDIPHTHERITIC POLYNEURITIS

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Abstract
Post-diphtheritic polyneuritis has been remarkably consistent in its course in the 53 patients reported. The spinal fluid exhibits the Guillain-Barre syndrome of an increase in protein without an increase in cell count more consistently than does the disease descr. by Guillain and Barre themselves. The mortality rate was 9.4%. All the fatalities occurred in patients who had recieved antitoxin either late in the disease or not at all. Paralysis also was seen when the correct diagnosis had been delayed or missed. In this series post-diphtheritic polyneuritis was not decreasing in frequency, and in recent yrs. indiscriminate use of antibiotics is increasing the number of delayed diagnoses. The clinical and spinal fluid findings are compared to those of 40 patients with polyneuritis of unknown etiology. Of these 40 patients 13 had had an infectious disease, 12 had diabetes, 1 had dermatomyositis, and 2 had received injns. of animal proteins. It is likely that an allergic response of the nerve cell to a foreign substance is involved in both the polyneuritis due to diphtheria toxin and in that of unknown etiology. In that case, if used early in the course of the disease, ACTH or cortisone should be effective in both.

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