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June 19, 1954


Author Affiliations

6410 Fannin St. Houston 25, Texas.

JAMA. 1954;155(8):775. doi:10.1001/jama.1954.03690260067029

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To the Editor:  —The case report in The Journal May 15, 1954, page 252, by Grant and Leopold, of Guillain-Barré syndrome occurring during cortisone therapy was of extreme interest and importance. The report indicates that resumption of cortisone (100 mg. daily) and later hydrocortisone (60 mg. daily) may have been a factor in the improvement that occurred after the second week. From my own experience with two cases and from the reported experience of others, it appears that large doses (200 to 400 mg.) of cortisone are necessary to relieve paralysis and that treatment must be continued throughout the period during which symptoms would be expected to endure. Premature diminution or cessation of cortisone administration has been responsible for severe relapses. Rather than curing the Guillain-Barré syndrome, cortisone appears to keep paralysis in abeyance until the episode runs its course. For the stated reasons, it is not too surprising that

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