In 1921, a dozen years before he became president of the U.S., Franklin Delano Roosevelt was stricken with polio. Or so history tells us. Now researchers at the University of Texas Medical Branch in Galveston suggest that the 32nd president may in fact have suffered from a disease known as Guillain-Barr syndrome instead.

Armond Goldman and his colleagues analyzed Roosevelt's reported symptoms--from personal correspondence, recollections by family members and medical records--as well as records of the incidence of polio and other diseases among adults. Their findings, published in the November issue of the Journal of Medical Biography, suggest that FDR's symptoms--particularly the late onset of the disease, the symmetrical nature of his paralysis, early facial paralysis and bladder and bowel dysfunction--"were inconsistent with paralytic poliomyelitis that affects motor neurons but were typical of Guillain-Barr syndrome, an autoimmune disease that damages sensory and motor nerves," Goldman says. Based on attack rates of polio in the Northeastern United States in the early 1900s and more recent data on Guillain-Barr syndrome diagnoses, the researchers determined that there was a 39 percent probability that polio caused Roosevelt's symptoms, compared to a 51 percent chance that they were brought on by Guillain-Barr syndrome. In addition, in a statistical analysis of eight clinical features exhibited by Roosevelt, six favor the Guillain-Barr diagnosis, whereas two favor polio.

"No one can be absolutely sure of the cause of Roosevelts paralysis because relevant laboratory diagnostic studies were not performed or were not available at the time of his illness," Goldman notes. In addition, satisfactory treatment for Guillain-Barr syndrome (which was only characterized in 1916) did not surface until decades later, so FDR's prognosis would have remained the same. Indeed, a different diagnosis may have been detrimental, because FDR went on to create the March of Dimes charity, which supported rehabilitation efforts for victims of paralytic poliomyelitis and the development of vaccines to prevent poliovirus infections.