Intrathecal immune response in patients with the post-polio syndrome

Article Abstract:

Poliomyelitis, usually called simply 'polio,' is an acute viral disease that affects nerve cells, predominantly in the spinal cord. The resulting damage to nerve cells often causes atrophy of the muscles served by these cells and permanent paralysis. It has long been recognized that some patients develop new muscle atrophy years or even decades after recovery from their acute polio infection. This condition, which is called post-polio syndrome, has been attributed to attrition of the remaining neurons which serve the muscles. However, recent studies have found abnormalities occurring in the immune system during post-polio syndrome. These findings suggest that post-polio syndrome may be more than merely attrition of nerve cells in a patient who has already lost many from the early attack of acute polio. Researchers have now found signs indicating that post-polio syndrome may actually be the result of a recurring active poliovirus infection. Because the brain and spinal cord are carefully protected by a barrier isolating them from direct contact with circulating blood, the researchers analyzed the cerebrospinal fluid (CSF), which bathes the brain and spinal cord, for the presence of antibodies and interleukin-2. The results from 36 patient with post-polio syndrome were compared with those from 67 control subjects. Among these control subjects were 13 patients who had polio but did not have post-polio syndrome, as well as 18 patients with amyotrophic lateral sclerosis, a disease which is distinct from polio but which also affects motor neurons. Twenty-one of the patients with post-polio syndrome were found to have increased amounts of antibody to the poliovirus in their CSF. This antibody was of the IgM class, which often indicates an active or recent infection. Antibodies were not increased to viruses tested other than polio. Increased amounts of interleukin-2 and soluble interleukin-2 receptors were also detected among the patients; these substances indicate an active immune response of some sort. These findings suggest that in at least some of the patients with post-polio syndrome, the condition may represent the reactivation of a latent infection of poliovirus. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Development and progression, Poliomyelitis, Atrophy, Muscular, Muscular atrophy

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Intrathecal baclofen for severe spinal spasticity

Article Abstract:

The authors studied the effect of injections of baclofen, a muscle relaxant, into the spinal cord of 20 patients with either spinal muscle spasms and an increased level of spinal muscle tone caused by multiple sclerosis or spinal cord injuries. Because the patients had previously not responded to oral administration of the drug, baclofen was injected through the sheath enclosing the spinal cord. Muscle tone, the degree of resistance to passive stretching, decreased in all 20 patients and spasms decreased in 18 of the 19 patients who had spasms. Intrathecal injection of baclofen is an effective long-term treatment for those patients with spinal spasms who do not respond to oral baclofen.

Care and treatment, Research, Drug therapy, Spinal diseases, Spasticity, Baclofen

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Effects of intrathecal morphine on the ventilatory response to hypoxia

Article Abstract:

Morphine suppresses respiration for longer periods of time when it is injected into the spinal column than when it is given intravenously. This indicates that morphine and other opioids can directly affect the central nervous system.

Respiration, Morphine

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