Methylprednisolone multiple sclerosis

The effects of prednisone on memory have been assessed (SEDA-21, 413 90). Glucocorticoid-treated patients performed worse than controls in tests of explicit memory. Pulsed intravenous methylprednisolone (2.5 g over 5 days, 5 g over 7 days, or 10 g over 5 days) caused impaired memory in patients with relapsing-remitting multiple sclerosis, but this effect is reversible, according to the results of an Italian study (91). Compared with ten control patients, there was marked selective impairment of explicit memory in 14 patients with relapsing-remitting multiple sclerosis treated with pulsed intravenous methylprednisolone. However, this memory impairment completely resolved 60 days after methylprednisolone treatment. 

Oliveri RL, Sibilia G, Valentino P, Russo C, Romeo N, Quattrone A. Pulsed methylprednisolone induces a reversible impairment of memory in patients with relapsing-remitting multiple sclerosis. Acta Neurol Scand 1998 97(6) 366-9. 

Sloka JS, Stefanelli M. The mechanism of action of methylprednisolone in the treatment of multiple sclerosis. Mult Scler. 2005 11 425M32. 

Barnes D, Hughes RA, Morris RW, Wade-Joues O, Browu P, Britton T, Francis DP, Perkin GD, Rudge P, Swash M, Kadifi H, Fanner S, Frankel J (1997) Randomized trial of oral and intravenous methylprednisolone in acute relapses of multiple sclerosis. Laucet 349 902-906. 

An anaphylactoid reaction (angioedema, generalized urticaria, worsening bronchospasm, and marked hypotension) occurred in a 35-year-old man with multiple sclerosis who became allergic to methylprednisolone (dose not stated) after starting treatment with interferon beta-lb (258). He had previously been treated with different courses of methylprednisolone. Clinicians should be aware that the complexity of the effects of interferon beta-lb on the immune system can lead to unexpected outcomes. It is uncertain whether the sequence of events here was due to an effect of interferon beta-lb or to coincidence. 

Smith DR, Balashov KE, Hafler DA, Khoury SJ, Weiner HL. Immune deviation following pulse cyclo-phosphamide/methylprednisolone treatment of multiple sclerosis increased interleukin-4 production and associated eosinophiha. Ann Neurol 1997 42(3) 313-18. 

Multiple sclerosis Methylprednisolone, beta interferons, glatiramer acetate, antispasmodics, anticholinergics Weakness, paresthesias, vision, injection technique... 

An individual case of a 45-year-old female with multiple sclerosis who presented to the emergency department with symptomatic sinus bradycardia after the completion of a high-dose oral prednisone therapy for multiple sclerosis-related optic neuritis has been reported [6 ]. She received l,250mg of oral prednisone per day for 5days in total and finished her course 3 days before her emergency department presentation. The patient s pulse rate and symptoms resolved on their own a week after the completion of the high-dose prednisone. There are very few adult cases that report this side effect and all of them have been with intravenous methylprednisolone. This is the first case report of a patient with symptomatic bradycardia from an oral CS regimen. 

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