[Reversible paraplegia following intrathecal injection of high doses of human gammaglobulins in the treatment of low-grade tetanus. 4 cases].

Intrathecal serotherapy appears to be effective in the treatment of tetanus, and it has been claimed that human immune globulins are innocuous. In the 4 cases reported here reversible paraplegia developed a few hours after intrathecal injection of 1500 to 2000 UI of human immune globulins prepared by the French Blood Transfusion Centre. We believe that paraplegia was related to the high doses administered. The fact that intrathecal serotherapy is normally used in severely ill patients whose impaired consciousness precludes motricity and sensitivity testing may explain why this complication has not previously been reported. The need for high doses of intrathecal immune globulins is discussed. It has recently been suggested that high doses are superior to low doses. We consider that this form of treatment is justified, even in the least severe forms of tetanus, but we feel that doses higher than 1000 IU are not without danger.