Plasma Exchange for Patients with Acute CNS Inflammatory Demyelinating Attacks

With PLEX treatment, neurologic improvement was marked or moderate in more than half of steroid-refractory patients in a historical cohort.

Plasma exchange (PLEX) is commonly used to treat patients with central nervous system inflammatory demyelinating attacks who do not respond to corticosteroid therapy. In a previously published, randomized, sham-controlled trial involving 22 such patients, neurologic improvement occurred significantly more often after PLEX treatment than after sham treatment (42% vs. 6% of courses; Ann Neurol 1999; 46:878).

Researchers now describe outcomes in a historical cohort of 153 Mayo Clinic patients treated with PLEX for acute, steroid-refractory CNS inflammatory demyelinating disorders. At the time of PLEX, 48% of the cohort had definite or probable multiple sclerosis (MS), 24% had longitudinally extensive transverse myelitis (LETM), 17% had neuromye…

Reviewing Author

Jeffrey M. Gelfand, MD