EFFECT OF INTRATHECAL PURIFIED PROTEIN DERIVATIVE OF TUBERCULIN IN MULTIPLE SCLEROSIS

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Abstract
No favorable effects were found in 36 multiple sclerosis patients treated with intrathecal purified protein derivative (P.P.D.). Following an observation period of from 16 to 34 months most cases deteriorated and there was a high relapse rate. Immediate complications and reactions included severe headache, drowsiness, pyrexia, nausea, pains in the limbs, neck stiffness, photophobia and other signs of meningeal irritations. Bladder complications were common and the usual type was acute retention. Severe nocturnal pain in the trunk attributed to spinal arachnoiditis resulting from the injection of P.P.D. was given as a late complication occurring after 10-11 months. Thirty relapses occurring in 24 of the 36 patients were noted during the first post-injection year. It is suggested that some naturally occurring relapses might be caused by an immunological stimulus. Considering the variable composition of P.P.D. and the possibility of it containing encephalitogenic substances it is doubtful that it should be injected intrathecally.