Tag Archives: Prednisone

Depression and Chronic Medical Illness

The Mind-Body Connection In Chronic Illness How Chronic Illness Affects Your Mood Some chronic medical illnesses may have direct effects on mood and energy. Thyroid conditions often cause fatigue and low mood. Neurological conditions like stroke or multiple sclerosis may affect parts of the brain that regulate mood and emotions. Major medical events like a… Read More »

Acute Treatments

Most patients with multiple sclerosis (MS) experience relapses characterized by acute or subacute neurological dysfunction lasting days to several weeks followed by a remission with partial or complete resolution of neurological dysfunction. Attacks may occur as part of diverse demyelinating syndromes: clinically isolated syndromes [e.g., isolated optic neuritis (ON), myelitis, or brainstem syndromes], relapsing-remitting multiple… Read More »

Treatment With Corticosteroids

It is common practice to prescribe high-dose methylprednisolone for treatment of acute relapses. methylprednisolone binds to albumin and glucocorticosteroid-binding globulin at low-doses. The blood-brain barrier has limited permeability to these protein complexes. high-dose methylprednisolone, however, saturates the binding proteins and has higher free levels in serum, thereby facilitating its crossing the blood-brain barrier. Methylprednisolone reduces… Read More »

Intravenous Immunoglobulin

Intravenous immunoglobulin treatment is effective for a number of immune-mediated demyelinating conditions such as Guillain-Barre syndrome or chronic inflammatory demyelinating poly-neuropathy. The role of intravenous immunoglobulin in treatment of multiple sclerosis is less clear. Most clinical trials have focused on long-term effects of intravenous immunoglobulin in relapsing-remitting multiple sclerosis and secondary progressive multiple sclerosis. The… Read More »

Acute Treatment: Cyclophosphamide

Cyclophosphamide is an alkylating agent with immunosuppressive properties and is commonly used in treatment of immune-mediated disease. The role of cyclophosphamide in multiple sclerosis has been studied extensively, and the current literature supports its use in active inflammatory demyelination. Uncontrolled data suggests that cyclophosphamide may be an effective alternative for treatment of rapidly worsening multiple… Read More »

Disease-modification trial designs

Molecular biology and epidemiology are generating targets for disease modification. But how are attempts to hit these targets be assessed? For a disease that in which the person deteriorates relentlessly, to distinguish between symptomatic treatment and disease modification is not simple. The first steps in attempts at modification of Alzheimer’s disease progression, and the scientific… Read More »

Chronic Headache & Steroids

Steroids: A. Have proven benefit in withdrawal therapy following medication overuse headache (MOH). B. Have proven benefit in prevention of headache relapse after acute migraine headaches. C. May cause aseptic osteonecrosis with short-term, intermittent pulse doses in migraine patients. D. Are contraindicated in acute vestibular neuritis. E. All of the above The answer is C.… Read More »

Which preventative drug gives the most rapid relief of CH?

Which preventative medication gives the most rapid relief of CH? A. Verapamil (Calan) B. Lithium C. Indomethacin (Indocin) D. Corticosteroids E. Gabapentin (Neurontin) The answer is D. Although verapamil (Calan) is the preventative drug of choice in patients with CHs, it may require escalation of the dose over time to be effective. Likewise, lithium needs… Read More »

Antiepileptic Drugs

Antiepileptic drugs are a class of medications developed to treat people with seizures. Tremendous effort and resources have been dedicated to epilepsy research. In the last years new antiepileptic drugs have become available for use. Even more surprisingly, these drugs have been found to improve the lives of people with a variety of medical disorders… Read More »