[Rapid modification of the symptomatology of progressive forms of multiple sclerosis by plasma exchange]

Twelve consecutive patients with a progressive form of multiple sclerosis were submitted to 6 sessions of plasma exchange as single therapy. Results were evaluated by Mac Alpine's, Kurtzke's, a simplified semi-quantitative neurologic validity scale and by determination of 4 totally objective quantitative parameters. A decrease in the disability score, according to Kurtzke, was noted in 4 patients, and comparison of scores of neurologic validity before and after plasma exchange showed a highly significant difference (p less than 0.0001). A significant effect was noted also for two of the quantitative parameters. The effect was predominant on pyramidal and cerebellar disorders. Improvement was rapid but transient and did not persist after 2 months. Theoretically, this improvement after plasma exchange implies the existence of circulating neuro-inhibitory factors and that multiple sclerosis is a disease not limited to the central nervous system. Indications for plasma exchange in the progressive form of multiple sclerosis are discussed.