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Laboratory Studies After Intrathecal Corticosteroids:  Determination of Corticosteroids in Plasma and Cerebrospinal Fluid

ARJUN D. SEHGAL, MD; DEVINA C. TWEED, PhD; W. JAMES GARDNER, MD; MARY K. FOOTE, BS
Arch Neurol. 1963;9(1):64-68. doi:10.1001/archneur.1963.00460070074007.
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Introduction  Methylprednisolone acetate* has been administered intrathecally in more than 1,000 patients for the treatment of neurologic disorders1-3 during the last three years. The treatment has proved safe, and the results are encouraging. It has become a standard method of treatment for arachnoiditis resulting from trauma, Pantopaque, or laminectomy. With this new method of administration we thought it expedient to ascertain: first, how long methylprednisolone acetate remains in the cerebrospinal fluid after intrathecal administration; secondly, whether methylprednisolone acetate injected at the lumbar level is dispersed evenly throughout the subarachnoid space, or remains in a higher concentration at the site of injection, by analyzing fluids obtained simultaneously at lumbar and cisternal punctures; thirdly, the duration of action of the steroid as judged by the effect on endogenous secretion of corticosteroids; fourthly, the effect on spinal fluid pressure, protein and cell content of various amounts of methylprednisolone acetate.

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