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FAMILIAL ATAXIC DIPLEGIA WITH DEFICIENT CELLULAR IMMUNITY A New Clinical Entity

In 1966 a girl with vaccinia gangrenosa successfully treated with N-methylisatin /3-thiosemicarbazone (Marboranm, Burroughs Wellcome & Co.) was reported 1(8). During recovery, at the age of 15 months, she was found to have an ataxic diplegia which had not been observed previously. At that time it was not known whether the neurological defect was 1) a sequela of the severe disease, 2) a toxic sideeffect of MarboranB, or 3) unrelated to the disease and its treatment. Later on a younger brother, who had not been vaccinated against variola, was found to have an identical neurological syndrome. Both siblings also showed evidence of deficient cellular immunity. At the age of 4 3/4 years the girl died of generalized varicella during steroid treatment of a hemolytic anemia. The post mortem examination, reported elsewhere (l), revealed pathological findings in the central nervous system thought neither to be due to the final acute disease nor to the vaccinia gangrenosa or its treatment. The aim of this paper is to complete the previous reports (1, 8) with a detailed neurological follow up of the two siblings, and with immunological data on the younger boy.