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Plasmapheresis in acute episodes of fulminant CNS inflammatory demyelination

Department of Neurology (Drs. Rodriguez, Karnes, and Bartleson) and the Section of Transfusion Medicine (Dr. Pineda), Mayo Clinic and Mayo Foundation, Rochester, MN.

We present six patients with acute fulminant episodes of CNS inflammatory demyelination who responded to therapeutic plasmapheresis after failing a course of high-dose methylprednisolone administered IV. Neurologic improvement occurred in three of the patients following the second plasmapheresis. Dramatic improvement in motor function (four patients) and language (two patients) began within 2 to 14 days and persisted during the 6 to 35 months (mean, 15 months) of follow-up. Results of this uncontrolled study suggest that plasmapheresis in the absence of other immunosuppressive drugs may have a role in the treatment of severe episodes of inflammatory demyelination in a select subset of MS patients.

Address correspondence and reprint requests to Dr. Moses Rodriguez, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Received September 14, 1992. Accepted for publication in final form October 1, 1992.

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