Contrast sensitivity improvement with sulfamethoxazole and trimethoprim in a patient with Machado-Joseph disease without spasticity.

A double-blind, placebo controlled, cross-over trial of sulfamethoxazole and trimethoprim was performed in a 62-year-old male patient who suffered from Machado-Joseph disease for 25 years. The patient, with cerebellar ataxia, akinetic-rigid syndrome and motor weakness but without any pyramidal features, had been chair-bound for 3 years before the trial. Bactrim therapy markedly improved performance on a physical examination which tested standing and gait, as compared to placebo session. Walker-assisted gait was possible again. For the first time, evaluation of spatio-temporal contrast sensitivity was performed and also revealed an improvement after Bactrim therapy as compared to placebo. These results suggest that Bactrim may be effective in degenerative neurological diseases and that Bactrim may have an overall effect on neurotransmission rather than solely possessing antispastic properties.