Irreversible neurological worsening following high-dose corticosteroids in advanced progressive multiple sclerosis.
BACKGROUND
A course of high-dose corticosteroids has been shown to hasten recovery from a relapse of multiple sclerosis (MS). Some patients with progressive MS ask for a course with corticosteroids outside a relapse, hoping to gain some functional improvement.


OBJECTIVE
To describe 4 patients with advanced progressive MS who experienced worsening of disability after treatment with high-dose corticosteroids.


RESULTS
All 4 patients had moderate to severe disability and asked for corticosteroid treatment because they were slowly progressing. None of them had a relapse. All experienced improvement by the end of the treatment course. One or 2 days after discontinuation of treatment, however, they deteriorated clinically and became more disabled than before treatment.


CONCLUSIONS
The use of high-dose corticosteroid therapy in progressive forms of MS outside relapses can be detrimental and worsen disability.
Koch
Marcus
M
Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands. m.w.koch@neuro.umcg.nl
De Keyser
Jacques
J
D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D004185:Disability Evaluation; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy*; D017211:Treatment Failure
D000305:Adrenal Cortex Hormones