Background: Intravenous methylprednisolone (IVMP) has been shown to hasten recovery from attacks of multiple sclerosis (MS) without altering the long term evolution of the condition; however, there is little evidence available to suggest which patients are more likely to benefit from IVMP treatment. Objective: To measure clinical change after IVMP treatment and to identify predictors of good outcome. Methods: Retrospective open-label study of medical records from 51 patients with clinically isolated syndromes or relapsing-remitting MS treated with IVMP for an acute attack (54 attacks). Results: A measurable neurological improvement was observed at one month in 44% of these attacks; the only predictor of Expanded Disability Status Scale (EDSS) change at one month was the severity of the attack. Conclusion: Attack severity predicts good response to IVMP when measured by means of EDSS.
Busaferri F , Candelise L.Steroids for multiple sclerosis and optic neuritis: a meta-analysis of randomized controlled clinical trials . J Neurol2000; 247: 435-442 .
2.
Miller DM , Weinstock-Guttman B , Bethoux F , Lee JC , Beck G , Block Vet al.A meta-analysis of methylprednisolone in recovery from multiple sclerosis exacerbations . Mult Scler2000; 6: 267-273 .
3.
Tremlett HL , Luscombe DK , Wiles CM.Use of corticosteroids in multiple sclerosis by consultant neurologists in the United Kingdom . J Neurol Neurosurg Psychiatry1998; 65: 362-365 .
4.
European Study Group on Interferon Beta-1b in Secondary Progressive MS.Placebo-controlled multicentre randomised trial of interferon beta-1b in treatment of secondary progressive multiple sclerosis . Lancet1998; 352: 1491-1497 .
5.
Jacobs LD , Beck RW , Simon JH , Kinkel RP , Brownscheidle CM , Murray TJet al.Intramuscular interferon beta-1a therapy initiated during a first demyelinating event in multiple sclerosis . N Engl J Med2000; 343: 898-904 .
6.
Durelli L , Cocito D , Riccio A , Barile C , Bergamasco B , Baggio GFet al.High-dose intravenous methylprednisolone in the treatment of multiple sclerosis: clinical-immunological correlations . Neurology1986; 36: 238-243 .
7.
Milligan NM , Newcombe R , Compston DAS.A double-blind controlled trial of high dose methylprednisolone in patients with multiple sclerosis: 1. Clinical effects . J Neurol Neurosurg Psychiatry1987; 50: 511-516 .
8.
Kurtzke JF.Rating neurological impairment in multiple sclerosis: an expanded disability status scale (EDSS) . Neurology1983; 33: 1444-1452 .
9.
Barnes D , Hughes RAC , Morris RW , Wade-Jones O , Brown P , Britton Tet al.Randomised trial of oral and intravenous methylprednisolone in acute relapses of multiple sclerosis . Lancet1997; 349: 902-906 .
10.
Montalban X , Nos C.Treatment of relapses: update on steroids, mode of action, optimal route and dosage. In Kappos L , Johnson K , Kesselring J , Radü EW eds. Multiple sclerosis: tissue destruction and repair. London, UK: Martin Dunitz , 2001: 257-265.
11.
Poser CM , Paty DW , Scheinberg L , McDonald WI , Davis FA , Ebers GCet al.New diagnostic criteria for multiple sclerosis: guideline for research protocols . Ann Neurol1983; 13: 227-231 .
12.
McDonald WI , Compston A , Edan G , Goodkin D , Hartung HP , Lublin FDet al.Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the diagnosis of multiple sclerosis . Ann Neurol2001; 50: 121-127 .
13.
Lublin FD , Reingold SC.Defining the clinical course of multiple sclerosis: results of an international survey . Neurology1996; 46: 907-911 .
14.
Lienert C , Lechner-Scott J , Mü ller U , Kappos L.Reliability of EDSS and FS-score rating can be improved by standardised training . Mult Scler2002; 8: S33-S33 .
15.
Montalban X , Tintore M , Rio J , Galan I , Codina A.Interobserver variability in the evaluation of functional systems and Kurtzke expanded disability status scale in a multiple sclerosis patient . Rev Neurol1996; 24: 630-632 .
