Treatment of stable chronic demyelinating polyneuropathy with 3,4- diaminopyridine

J. W. Russell, Anthony John Windebank, C. M. Harper

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

Objective: To determine whether 3,4-diaminopyridine (3,4-DAP) would improve clinical or electrophysiologic function in patients with stable chronic demyelinating polyneuropathy. Design: We conducted a prospective, randomized, placebo-controlled, blinded, crossover study of 3,4-DAP in 34 patients with demyelinating polyneuropathy. Material and Methods: Of the 17 men and 17 women, who were 21 to 80 years of age, 27 had hereditary motor and sensory neuropathy type I and 7 had acquired demyelinating polyneuropathy. Treatment consisted of stepped doses of 3,4-DAP (increasing to 20 mg four times daily) or placebo for 4 days. Pretreatment and posttreatment determination of the Neurologic Disability Score (NDS); isometric muscle strength testing; median, ulnar, and peroneal nerve conduction studies; and measurement of serum 3,4-DAP were performed. Quantitative computer-assisted sensory examinations were done in five patients. Results: The results for the final day of treatment with 3,4-DAP or placebo and the differences between pretreatment and posttreatment findings for total NDS, sensory NDS, isometric muscle strength testing, compound muscle action potential amplitude, sensory nerve action potential amplitude, motor and sensory conduction velocities, and vibration and cold detection thresholds did not vary significantly. A small improvement of 4 points in the motor NDS (P<0.05) was found. Five patients with electrophysiologic conduction block had no significant reduction in the degree of block. Conclusion: Because no improvement was noted in most measurements of neurologic function, despite use of high doses of drug, 3,4-DAP is unlikely to be beneficial in the treatment of stable chronic demyelinating polyneuropathy.

Original languageEnglish (US)
Pages (from-to)532-539
Number of pages8
JournalMayo Clinic Proceedings
Volume70
Issue number6
StatePublished - 1995

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Polyneuropathies
Nervous System
Placebos
Muscle Strength
Action Potentials
Therapeutics
Hereditary Sensory and Motor Neuropathy
Peroneal Nerve
Ulnar Nerve
Median Nerve
Neural Conduction
Neurologic Manifestations
Vibration
Cross-Over Studies
3,4-diaminopyridine
Muscles
Serum
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Treatment of stable chronic demyelinating polyneuropathy with 3,4- diaminopyridine. / Russell, J. W.; Windebank, Anthony John; Harper, C. M.

In: Mayo Clinic Proceedings, Vol. 70, No. 6, 1995, p. 532-539.

Research output: Contribution to journalArticle

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