A TREATMENT FOR ATAXIA

How can a medication work on one side of the Rhine and not the other? The articles by Trouillas et al1 and Wessel et al2 in this issue of the Archives illustrate in many ways the causes and types of disagreement about the effect of an experimental drug on a constellation of symptoms. The levorotatory form of hydroxytryptophan (l-5-hydroxytryptophan), a serotonin precursor, has been used for a decade or more by Trouillas et al1 and others in an attempt to treat ataxia of various causes. Studies have evolved from early unblinded attempts to these two double-blinded studies.1,2 Trouillas and coworkers originally found the most benefit in treating those patients with noninherited ataxia. In the present study,1 they concentrated on 19 persons with Friedreich's ataxia from 11 centers, whereas the study by Wessel and coworkers2 included 39 patients from three centers: 19 with Friedreich's. © 1995 Arch Neurol All rights reserved.