THURSDAY, Oct. 30, 2003 (HealthDayNews) -- Was the world's most famous polio patient misdiagnosed?
Four doctors and a statistician from Texas think so, and they're proposing that President Franklin D. Roosevelt was actually crippled by a rare condition missed by his physicians.
In a study, the doctors said a statistical analysis suggests a disorder known as Guillain-Barré syndrome attacked his brain and forced Roosevelt to spend the rest of his life in a wheelchair.
No so fast, says a skeptical polio expert who pounced on the study findings. "I would say they're barking up the wrong tree," says Dr. Lauro S. Halstead, director of the Post-Polio Program at the National Rehabilitation Hospital in Washington, D.C.
Diagnosing Roosevelt's medical problems nearly 60 years after his death may sound like, as Halstead puts it, a "purely intellectual exercise."
But Roosevelt's illness remains an object of great fascination, especially considering that he was a man who went to great pains to hide his paralysis from his country but also helped create the anti-polio organization that became the March of Dimes. Apparently, no one has doubted his true illness until now.
"This particular speculation is something new," says Raymond Teichman, head archivist at the Franklin D. Roosevelt Library.
Roosevelt's troubles began in 1921 when his family went on vacation to New Brunswick, Canada. He fell into the cold ocean waters on Aug. 9, but seemed unaffected and spent the next day jogging and swimming.
By Aug. 13, Roosevelt was paralyzed from the chest down and needed assistance with basic bodily functions. He eventually regained the ability to have sex and use the restroom without help, but remained mostly paralyzed below the waist.
Doctors diagnosed Roosevelt with polio, even though he didn't come down with the disease in childhood like most victims. He was, in fact, 39 years old.
To Dr. Arnold Goldman, an immunology specialist and professor emeritus at the University of Texas Medical Branch, Roosevelt's age suggested the future president didn't have polio after all. He recruited colleagues, explored Roosevelt's medical records, and launched an analysis of his age and symptoms to figure out the odds that he had polio.
The findings of the study appear in the November issue of the Journal of Medical Biography.
Goldman and his co-authors report it's likely that Roosevelt suffered from Guillain-Barré (ghee-yan bah-ray) syndrome, named after two French researchers. Patients often develop the disorder after a bout with a virus or infection, and potentially deadly paralysis develops as the body's immune system turns on neurons in the brain.
Polio, by contrast, is an infectious disease, caused by a virus, that destroys neurons that contribute to body movement and, in some cases, breathing itself. It mostly afflicts children and leaves them paralyzed for life.
If Roosevelt did have Guillain-Barré syndrome, why didn't his doctors pick up on it? At the time of FDR's illness, "Guillain-Barré was much better appreciated in Europe than in the United States," Goldman says, which isn't surprising considering that it was first described there.
Poor communication between the continents, exacerbated by World War II, didn't help Americans understand the disorder, he says. "I probably would have made the diagnosis [of polio] at that time," Goldman says. They may have been right, "but we don't think so."
Halstead, an expert in problems that polio patients develop later in life, isn't convinced. While the two disorders do share some symptoms, the onset of Roosevelt's illness sounds more like polio, said Halstead, who has studied FDR's medical history.
Among other things, patients with Guillain-Barré syndrome get better. "Recovery is sort of the rule," he says. "Most folks recover quite nicely."
But not always, Goldman points out.
Both Goldman and Halstead agree on one thing: At the time, Roosevelt could not have been cured, regardless of which illness he had. His paralysis was irreversible.
Also, millions of people were saved from polio in part because of FDR's diagnosis. The March of Dimes, which he helped found, hired many researchers, among them Dr. Jonas Salk, to focus on a vaccine.
To learn more about Guillain-Barré syndrome, check out the National Institute of Neurological Disorders and Stroke . Get details about FDR, polio and the March of Dimes from the Franklin D. Roosevelt Library.