Franklin Delano Roosevelt’s (FDR’s) (1882–1945) 1921 neurological disease revisited; the most likely diagnosis remains Guillain–Barré syndrome

In 2003, we published evidence that the most likely cause of FDR’s 1921 neurological disease was Guillain–Barre syndrome. Afterwards, several historians and neurologists stated in their publications that FDR had paralytic poliomyelitis. However, significant criticism of our article or new support for that diagnosis was not revealed. One critic claimed that FDR’s cerebrospinal fluid indicated poliomyelitis, but we did not find evidence that a lumbar puncture was performed. The diagnosis of FDR’s neurological disease still depends upon documented clinical abnormalities. His age, prolonged symmetric ascending paralysis, transient numbness, protracted dysaesthesia (pain on slight touch), facial paralysis, bladder and bowel dysfunction, and absence of meningismus are typical of Guillain–Barre syndrome and are inconsistent with paralytic poliomyelitis. FDR’s prolonged fever was atypical for both diseases. Finally, permanent paralysis, though commoner in paralytic poliomyelitis, is frequent in Guillain–Barre syn...