and Debbie asked,
I have a question-Where do you find the Merck Manual, when was it
>updated? The statement "Corticosteroids are of no proven benefit", does
>that pertain to every case, or do you tie it in with the previous sentence,
>which I would interpret as - "If it is related to a virus, then
>corticosteroids DO work".
>
>When I was hospitalized, and they started very aggressive diagnostics, I
>was started on Corticosteroids within 48 hours of onset, and immediately
>started improving. The doctors said that my positive response to the
>Corticosteroids actually confirmed the diagnosis of Transverse Myelitis.
>And from what I have been reading here, most of the people I have been
>reading about have all been on the Steroid treatment at one or more points
>of their treatment.
>
>The article you posted has left me really confused.
>
>Debbie
Later it looks likes Jim responsded that the manual he was referrring
to was a 1980 version. Last week I spent about three hours in the
university library and got a lot of information --some of it contradictory
BUT most of the recent publications indicate that corticosteroids are THE
treatment for TM -- the former line you refer to about a viral
meningoencephalitis would refer to almost all of us with this disorder -- it
really seems that a virus is the cause (of course there are THOUSANDS of
viruses and most of them are not identifiable but usual lab methods).
There is a lot of material on this disease written in a variety of
neuology texts --including a VERY confusing article in the Archives of
Neurology (1993) that seems --in my opinion to include in the study of 33 a
large group of people who do NOT have TM but other disoders --later on this
later --I am off to my out patient physio to try those damn long leg braces
again today ;-) I mention this article because it comes up if you use
Medline search and it it NOT encouraging.
anyway -- later -- and regarding Elavil --mentionned, i think by Dave,
don't be too put off --it has some VERY "heavy" side effects and if taken in
small doses --l0 or 25 mgm can help pain relief -- in it's usual
antidepressant doses --75 - 225 mgm you can be turned into a zombie -- which
does NOT happen for most SSRI (Procaz is the first of these) -- and NO all
the hype raised by the church of scientology is crap -- nothing they say was
ever proven and Lily did not pay a red cent to them --
Bryan