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To the Editor:—
It is my belief that typical multiple sclerosis (the condition occurring in young individuals and characterized by remissions and exacerbations and scattered neurological findings) is not a specific disease but perhaps a syndrome resulting from a variety of alterations. The frequent finding of an elevated or diabetic glucose tolerance curve in the multiple sclerosis syndrome has been reported by several different authors. It is my present feeling, on the basis of preliminary studies, that the use of antidiabetic therapy will often have beneficial effects in those multiple sclerotic patients having an elevated or diabetic glucose tolerance curve. Those patients, even with the typical picture of multiple sclerosis but showing no change in the glucose tolerance test, do not show response to tolbutamide. Also, any symptoms which have been present for a long time are less likely to respond. The dosage of tolbutamide is 0.5 gm. (twice daily,
Sawyer GT. Tolbutamide in Treatment of Multiple Sclerosis and Parkinsonism. JAMA. 1961;176(2):166. doi:10.1001/jama.1961.03040150082022
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