High dose steroids in acute relapses of multiple sclerosis: MRI evidence for a possible mechanism of therapeutic effect.

DH Miller, AJ Thompson, SP Morrissey… - Journal of Neurology …, 1992 - jnnp.bmj.com
DH Miller, AJ Thompson, SP Morrissey, DG MacManus, SG Moore, BE Kendall, IF Moseley…
Journal of Neurology, Neurosurgery & Psychiatry, 1992jnnp.bmj.com
The integrity of the blood-brain barrier (BBB) in multiple sclerosis (MS) was monitored by
serial gadolinium-(Gd)-DTPA enhanced MRI during and after the treatment of acute relapses
with a three day course of high dose intravenous methylprednisolone (IVMP). During
treatment there was a rapid reduction of BBB abnormalities in 96% of enhancing lesions. In
spite of sustained clinical improvement, many lesions re-enhanced within a few days of
stopping IVMP, and new lesions frequently appeared within one month. It is possible that the …
The integrity of the blood-brain barrier (BBB) in multiple sclerosis (MS) was monitored by serial gadolinium-(Gd)-DTPA enhanced MRI during and after the treatment of acute relapses with a three day course of high dose intravenous methylprednisolone (IVMP). During treatment there was a rapid reduction of BBB abnormalities in 96% of enhancing lesions. In spite of sustained clinical improvement, many lesions re-enhanced within a few days of stopping IVMP, and new lesions frequently appeared within one month. It is possible that the rapid, albeit transient, reversal of BBB abnormalities contributes to the accelerated recovery from relapses associated with IVMP treatment.
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