Pulse IV steroids for certain neuropathies might give prompt relief.
Rev Med Interne. 2011 Nov;32(11):e111-3.
Diabetic amyotrophy: Favorable outcome following corticosteroid therapy?
Jaspard M, Jacobi D, Praline J, Magnant J, Buzelé R, Couet C, Maillot F. abstract here
Diabetic amyothrophy:
- Diabetes
- Thigh muscle atrophy, weakness and pain
- weight loss
- Normal sensory and relfexes
- three days of IV boluses of 500 mg methylprednisolone – monthly for four months
- Followed by daily 25 mg prednisone
- Improvement in pain and strength allowed marked reduction of opioids and abandonment of wheelchair within 1 month.
Similar pulse therapy has been used in chronic inflammatory demyelinating polyneuropathy:
J Neurol Neurosurg Psychiatry 1997;62:388-390 doi:10.1136/jnnp.62.4.388
Pulsed high dose dexamethasone treatment in chronic inflammatory demyelinating polyneuropathy: a pilot study.
D S Molenaar, P A van Doorn, M Vermeulen abstract here
Rinsho Shinkeigaku. 1993 Feb;33(2):199-202.
Rapid recovery of chronic inflammatory demyelinating polyneuropathy induced by steroid pulse therapy–changes in nerve conduction
Hishida R, Baba M, Shimamura H, Matsunaga M, Takebe K. abstract here
- A 47-year-old female patient with chronic inflammatory demyelinating polyneuropathy started to recover from her numbness and weakness within a few hours following the commencement of intravenous methylprednisolone 1,000 mg
No To Shinkei. 2001 Dec;53(12):1115-8.
A quadriplegic patient with chronic inflammatory demyelinating polyneuropathy (CIDP) who responded well to corticosteroids and intravenous immunoglobulin therapy.
Fukae J, Okuma Y, Noda K, Fujishima K, Goto K, Mizuno Y.
so amazing I have included the abstract:
“We report an elderly patient with chronic inflammatory demyelinating polyneuropathy (CIDP) presenting with complete quadriplegia who responded well to the treatment. A 74-year-old woman was transferred to our hospital from a hospital for the elderly patients. The patient had a history of progressive limb weakness over three years, and has been quadriplegic for the last six months. The patient was unable to move her extremities, but neither respiratory nor bulbar dysfunction was observed. Deep tendon reflexes were absent. Glove and stocking type sensory disturbance was noted. Nerve conduction studies showed slowed motor and sensory conduction velocities with diminished compound muscle action potentials (CMAP). Abnormal temporal dispersion and conduction blocks were also demonstrated. Cerebrospinal fluid examination revealed an elevated protein level of 78 mg/dl with normal cell counts. The patient was diagnosed as having CIDP.
She was treated with methylprednisolone pulse therapy and oral prednisolone, followed by high dose intravenous immunoglobulin treatment. Significant recovery occurred during the first week, and she became able to walk four months later.Motor nerve conduction velocity (MCV) and CMAP were also improved. It is suggested that CIDP must be considered in patients with quadriplegia of unknown etiology: such patients may be seen in hospitals for elderly patients.”