title: Paget's disease. Reversal of severe paraparesis using calcitonin.
abstract: Relatively short-term treatment of paraparesis due to Paget's disease with subcutaneous salmon calcitonin alone produced dramatic relief of sensory loss, pain, and paraparesis. The successful outcomes in 2 patients, one with spinal cord and one with cauda equina compression, indicate a potential alternative to surgery in reversing mild-to-severe neural dysfunction in Pagets disease. The proposed mechanisms of action of calcitonin include reduction of a direct bony impingement on the neural tissue and/or a decrease of neural ischemia. It is suggested that even if paraparesis does not improve with calcitonin alone, the medication given preoperatively would probably serve a useful adjunctive role by decreasing intraoperative bone bleeding. However, those patients whose pagetic bone is already metabolically inactive would probably not benefit from calcitonin therapy.
mesh_terms: D002116:Calcitonin / Q000627:therapeutic use*; D006801:Humans; D008159:Lumbar Vertebrae / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010001:Osteitis Deformans / Q000150:complications* / Q000473:pathology / Q000503:physiopathology; D010243:Paralysis / Q000188:drug therapy* / Q000209:etiology; D013116:Spinal Cord / Q000503:physiopathology
chemical_list: D002116:Calcitonin