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February 1988

Effect of Sulfamethoxazole and Trimethoprim on Neurologic Dysfunction in a Patient With Joseph's Disease

Author Affiliations

From the Departments of Medicine (Dr Mello) and Neurology (Dr Abbott), St Luke's Hospital, New Bedford, Mass.

Arch Neurol. 1988;45(2):210-213. doi:10.1001/archneur.1988.00520260098028

• Joseph's disease, an autosomal dominant, degenerative neurologic disease found in the Portuguese, is clinically manifested by extrapyramidal, pyramidal, and cerebellar dysfunction. A patient with the type II form of the disease reported improvement in gait and lessened spasticity while taking sulfamethoxazole and trimethoprim (Bactrim) for a noninfectious dysuria syndrome. A double-blind, placebo-controlled trial of Bactrim utilizing a subjective performance scale, physical examination, and six timed tests was performed in this patient. Results revealed lessened spasticity, improvement in walker-assisted gait, and correlative subjective responses. These results suggest an antispasticity effect of Bactrim or one of its components in this patient.

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