title: Irreversible neurological worsening following high-dose corticosteroids in advanced progressive multiple sclerosis.
abstract: 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.
authors.affiliation: Department of Neurology, University Medical Center Groningen, Groningen, The Netherlands. m.w.koch@neuro.umcg.nl
authors.forename: Marcus
authors.initials: M
authors.lastname: Koch
authors.forename: Jacques
authors.initials: J
authors.lastname: De Keyser
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones