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Point of View

Raymond Troiano, MD; Stuart D. Cook, MD; Peter C. Dowling, MD

Arch Neurol. 1987;44(8):803-807.

Abstract
• A number of studies have demonstrated that high-dose corticosteroid treatment improves the rate of recovery from acute exacerbations of multiple sclerosis. The beneficial effect is more rapidly and consistently produced by high-dose corticosteroid administration than with adrenocorticotropic hormone. The most rapid improvement in clinical condition and cerebrospinal fluid parameters of patients has been observed with short courses of very high-dose intravenous therapy. This form of treatment would be most advantageous for patients with severe and rapidly progressive exacerbations. Ultimately, the duration of treatment will depend on the patient's response to treatment, tolerance of corticosteroid withdrawal, and the occurrence of significant complications of therapy. However, in our experience, a three- to four-month slowly tapered course of oral therapy is often needed, and is usually well tolerated, with few serious side effects when given once daily in the morning.

Author Affiliations
From the Neurology Service, University Hospital, University of Medicine and Dentistry of New Jersey (Drs Troiano, Cook, and Dowling), the Department of Neurosciences, New Jersey Medical School (Drs Troiano, Cook, and Dowling), Newark, and the Neurology Service, Veterans Administration Medical Center, East Orange, NJ (Drs Cook and Dowling).

Footnotes
Accepted for publication March 30, 1987.

Reprint requests to Division of Neurology, University of Medicine and Dentistry-University Hospital, 100 Bergen St, Newark, NJ 07103 (Dr Troiano).

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