Corticosteroids multiple sclerosis

About 80% of MS patients have an episodic form of the disease called relapsing-remitting multiple sclerosis. An episode typically starts with sensory disturbances, limb weakness, and clumsiness symptoms evolve over several days, stabilize, and then often improve spontaneously or in response to corticosteroids. In the initial phase of the disease, relapses are generally followed by complete or nearly complete clinical recovery. However, persistent signs of CNS dysfunction may develop after a relapse, and the disease... 

Albucher JF, Vuillemin-Azais C, Manelfe C, Clanet M, Guiraud-Chaumeil B, Chollet F. Cerebral thrombophlebitis in three patients with probable multiple sclerosis. Role 57. of lumbar puncture or intravenous corticosteroid treatment. Cerebrovasc Dis 1999 9(5) 298-303. 

Schwid SR, Goodman AD, Puzas JE, McDermott MP, Mattson DH. Sporadic corticosteroid pulses and osteoporosis in multiple sclerosis. Arch Neurol 1996 53(8) 753-7. 

The use of Echinacea is not recommended for patients with autoimmune conditions, such as multiple sclerosis and AIDS, or those taking drugs to suppress immune response (e.g., corticosteroids) (Blumenthal, 1998 Gruenwald et al., 2000). However, these recommendations appear to be based on speculation more than rigorous, peer-reviewed research. Research is needed to further support or refute the claim that individuals with autoimmune conditions should not use Echinacea. 

T6. Tourtellote, W. W., Ma, B. I., Baumhefner, R. W., Dickstein, P., Gowhig, G., Delmotte, P., and Potvin, A. R., Multiple sclerosis (MS) de novo central nervous system (CNS) IgG synthesis monitored by isotachophoresis (ITP), isoelectric focusing (lEF) Link s IgG Index, and an Empirical formula Effect of ACTH, corticosteroids, CNS X-ray and cytosine arabinoside. Proc. ITP 80, Elsevier, Amsterdam, 1981. 

In view of successful animal experiments (20 see also Chapter 14), a sustained-release dexamethasone device was implanted in one eye of a patient with bilateral severe uveitis associated with multiple sclerosis (20,21). The patient had previously undergone pars plana lensectomy and vitrectomy in the right eye for decreased vision associated with cataract. Despite chronic topical corticosteroids, the patient had persistent bilateral low-grade inflammation and recurrent severe bilateral iridocyclitis. Best corrected visual acuity was 20/400 in both eyes. Systemic corticosteroids and methotrexate controlled the intraocular inflammation but the patient was intolerant of these medications because of systemic side effects. The nondegradable dexamethasone device was inserted into the patient s left eye. 

Kaufman M. Treatment of multiple sclerosis with hi -dose corticosteroids may prolong the prothrombin time to dangerous levels in patients ta ng warfarin. Multiple Sclerosis (1997) 3, 248-9. 

There is no special treatment. Antihistamines and corticosteroids are very efficent and epinephrine is advisable in the rare cases of acute shock with or without edema of the larynx. After the accident, it is usually possible to treat the patient without the help of corticotrophin. However, in some cases, this treatment may appear necessary and in these cases desensitization has been attempted [with success in two cases of multiple sclerosis observed by Patriarca et al. (1974)]. 

Tselis A, Perumal J, Caon C, Hreha S, Ching W, Din M, Van Stavern G, Khan O. Treatment of corticosteroid refractory optic neuritis in multiple sclerosis patients with intravenous immunoglob-uUn. Eur J Neurol 2008 15(11) 1163-7. 

Skin/respiratory - sarcoidosis A female patient with multiple sclerosis developed sarcoidosis 3 years after continuous therapy with IFNp. The patient presented witir low-grade fevers, dyspnoea on exertion, diffuse arthralgias and rash. Noncaseating granulomas and endobronchial biopsies of pulmonary lymph nodes contributed to the diagnosis of sarcoidosis. Withdrawal of IFNp combined with a course of corticosteroids and antirheumatic drug therapy led to resolution of the condition [60 ]. 

---