Treating the untreatable.

Two drugs have recently challenged the notion that crippling spinal-cord injuries are untreatable. Tests conducted last year showed that high doses of the steroid methylprednisolone, administered within eight hours of spinal injury, could minimize paralysis in many patients (SN: 4/7/90, p.212). Researchers now report even more promising results from a small study of an experimental drug called GM-1 ganglioside.

At the University of Maryland Shock Trauma Center in Baltimore, neurosurgeon Fred H. Geisler and his colleagues studied 34 people with paralyzing spinal-cord injuries. Within three days of their injury, 16 of the patients began daily injections of GM-1 ganglioside for 18 to 32 days; the remainder received placebo injections. In nearly half of the treated patients, the drug apparently restored some motor skills to initially paralyzed muscles, the researchers report in the June 27 NEW ENGLAND JOURNAL OF MEDICINE. Moreover, immediate treatment was not crucial. Improvements showed up even in patients whose injections began three days after injury.

Geisler's team theorizes that GM-1 ganglioside -- naturally present in cell membranes of the brain and spinal cord -- helps protect against additional nerve-cell death after a spinal-cord injury, while also stimulating nerve-fiber growth and repair. The researchers caution that the drug does not fully heal the spinal cord, but they note a dramatic improvement in quality of life for some treated patients. Six who had been confined to wheelchairs can now walk with leg braces, they report, compared to one such case in the placebo group.