Ask a doctor on the topic of Neurology

Corticosteroid pulse therapy - Is it advisable or not?

December 28, 2013 | 25,00 EUR | answered by Dr. med. Kathrin Hamann

I have MS with predominantly relapsing-remitting course. The last relapse was in December of this year and I received 5000 mg of cortisone as a pulse therapy. The last 1000 mg on December 17, 2013. Some symptoms like tingling in my legs and hands have significantly improved, also my coordination and dizziness seem to be decreasing. But my legs are still partially extremely stiff and I feel like they don't belong to me, tingling and trembling are still present. This leg symptomatology is fluctuating, from almost gone to strongly present. Unfortunately, I react to cortisone with several side effects, such as trembling, sweating, unstable circulation, etc.

My question is, should I have another cortisone pulse therapy since there are still symptoms present, or should I wait. Could this possibly be a problem with tapering off cortisone?

Dr. med. Kathrin Hamann

Hello,

there may well be a withdrawal problem, but in any case I would continue to give cortisone to alleviate the leg discomfort that still persists partially. However, cortisone should no longer be given as a pulse therapy, but should be slowly reduced and tapered off to reduce withdrawal symptoms.

It is important to do physiotherapy, as I consider it to be an essential component of therapy. Please discuss this with your neurologist or general practitioner.

I am happy to help you further.

Best regards,

Dr. K. Hamann