COMPLICATIONS FROM INTRATHECAL STEROID THERAPY IN PATIENTS WITH MULTIPLE SCLEROSIS

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Abstract
Methylprednisolone acetate was administered intrathecally 83 times to 23 patients who had 46 separate exacerbations of multiple sclerosis. Four patients improved, 7 worsened, and 12 were unchanged during treatment and follow-up. Serious side effects occurred in 3 patients; adhesive arachnoiditis in 2, and aseptic meningitis in one. Three other patients had severe exacerbations within 24 hours of treatment, followed by slow improvement, or no improvement. When the clinical response of this patient group was evaluated and compared with other series, it was found that improvement occurred with chance frequency. Exacerbations continued to occur with natural frequency. These findings suggest that there is no rationale for this mode of therapy, as there are dangers from these intrathecal injections, and the treatment does not alter the course of the disease.