In a double-blind controlled trial of 194 patients with clinically definite active multiple sclerosis, 98 were randomized to treatment with cyclosporine (CyA, 5 mg/kg/day), and 96 to treatment with azathioprine (Aza, 2.5 mg/kg/day). Eighty-five patients in the CyA group and 82 in the Aza group completed a treatment period of 24 to 32 months in accordance with the study protocol. No significant differences could be detected between the two treatment groups at the end of the trial. Assessment was done by serial quantitative neurological examinations and Kurtzke's Expanded Disability Status Scale. Frequency of relapse and patient self-evaluation also failed to show significant differences. Overall deterioration observed in both groups during the trial was only minor. The incidence of side effects in the CyA group was more than two times that in the Aza group. We conclude that CyA as a single agent cannot be the drug of final choice in long-term immunosuppressive treatment of relapsing-remitting and relapsing-progressive multiple sclerosis.

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Mollaret's meningitis is a rare clinical entity consisting of recurrent attacks of meningeal irritation, which, after a sudden onset, last for a few days. The prognosis appears to be excellent, although the aetiology has not been established. In the CSF so-called endothelial cells are a typical finding, but their classification is not yet clear. In the present case immunocytological examination of CSF cells revealed that the so-called Mollaret cells are monocytes. The time course of changes in helper/suppressor ratio is similar to that in other infectious diseases of the central nervous system.

The course of multiple sclerosis was monitored by means of a long-term prospective study. This paper reports on first results from this study, covering 102 patients who were monitored for 2 years or more and examined regularly. It is attempted to quantify the extent of the worsening or improvement in the patients' clinical status over the period of observation using regression analysis techniques. The severity of the disease did not correlate to the period of observation in 15% of the cases, these displaying no progression with regard to the clinical signs. In most cases (32%) a description of the disease progression was possible by means of a linear regression line, 21% had a parabolic and 23.5% an increasingly progressive course. For nine patients a second or third degree polynomial regression curve could be used to describe the course of the disease. The individual progression of the disease as estimated using the linear regression coefficient did not correlate with the individual relapse rate (on average 1.1 per year), nor with the age of the patient, the severity of the multiple sclerosis, the duration of the illness or with the previous course of the disease.