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Focus on CSFF : A new treatment for Guillain-Barré syndrome?

"Cerebrospinal fluid (CSF) filtration" is also known as CSFF or "liquorpheresis". It is a treatment for bacterial meningitis and familial amyotrophic lateral sclerosis (ALS).
However, CSFF is also being researched as a treatment for Guillain-Barré syndrome (GBS) and Chronic Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), the idea being to combine CSFF and PE/IVIg for an improved treatment strategy.

Why use CSFF
GBS is characterised by an inflammation of the nerve roots in the spinal cord. The CSF appears to contain factors that may influence this and contribute towards blocking nerve conduction. Manipulating the surroundings of the nerve roots by purifying the CSF may reduce the inflammation.

How is CSFF carried out
A lumbal catheter is placed in the patient for the withdrawal and re-insertion of CSF. A bi-directional syringe pump is used to allow automatic flow- and pressure-controlled withdrawal and subsequent re-infusion of the CSF, via specially-developed filters. These filters eliminate cells, bacteria, endotoxins, immunoglobulins, inflammatory mediators and other factors. These are believed to exercise demyelinating activity on the spinal roots until removed by this process.

The method does not appear to have any serious side-effects, but is still not completely researched for use on GBS patients. Konrad Tibourzy is the only patient I know who has tried this treatment, unfortunately with adverse effects - the reason for the adverse effects is not clear.

Where can I find more information
Litterature on the subject is sparse, a short list of abstracts follows. If you have information not listed here, please send it in!

  • CSF filtration is an effective treatment of Guillain-Barre syndrome: a randomized clinical trial.
    Wollinsky et al. (Ulm, Germany).
    Neurology. 2001 Sep 11;57(5):753-4.
  • CSF filtration equivalent to plasma exchange for Guillain-Barré syndrome.
    Wollinsky KH, Hulser PJ, Brinkmeier H, et al.
    Neurology 2001;57:753-754,774-780

Other unchecked sources you could try (feedback on these is needed, please!):

  • Cerebrospinal fluid filtration for treating Guillain-Barre syndrome: is there any pathological background?
    Berciano J. Anaesthesia. 2000 Apr;55(4):408.
  • Cerebrospinal fluid filtration in Guillain-Barre syndrome.
    Urwin SC, Hunt P. Anaesthesia. 2000 May;55(5):503-4.
  • Drain the roots: a new treatment for Guillain-Barre syndrome?
    Feasby TE, Hartung HP. Neurology. 2001 Sep 11;57(5):753-4.
  • CSF-filtration : a new therapeutical concept.
    Kirschfink, Michael & S.Rother. In: Anaesthesia, Pain, Intensive Care, and Emergency Medicine. Ed. A.Gullo. Milano 1994, S. 577-586

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