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April 14, 1956


Author Affiliations

U. S. Army

United States Army Hospital Fort Belvoir, Va.

JAMA. 1956;160(15):1354-1355. doi:10.1001/jama.1956.02960500084023

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To the Editor:—  Numerous reports of convulsive seizures complicating prolonged therapy with cortisone or corticotropin have been published. Almost all of these reports have been of mild epileptiform seizures. The mechanism of these disturbances is not known, but the development of cerebral edema is one explanation that has been offered. None of the reports has described an attack so severe as to mimic a massive, terminal, cerebral hemorrhage. Such a case was, however, seen by us. On Dec. 30, 1954, a 64-year-old woman was admitted to the hospital in coma following a seizure of Jacksonian epilepsy. She had no previous history of hypertension, epilepsy, or other neurological disease but had been taking corticotropin and cortisone sporadically since 1951 for rheumatoid arthritis. In the year preceding admission she had received 25 to 50 mg. of cortisone daily. On admission she was semistuporous, answered questions vaguely, and lapsed into sleep if not

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