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| Focus on CSFF :
A new treatment for Guillain-Barré syndrome? |
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"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 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!):
-
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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Your donations
keep this site running. Please consider making
one if you've been helped thru "All about GBS"!
These donors have helped keep this site running in 2004-5:
Pam Graf, US
Konrad Tiburzy, GDR
Gabriele Wennemer, France |
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