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NEUROLOGY 1991;41:1349
© 1991 American Academy of Neurology

The effect of high-dose steroids on MRI gadolinium enhancement in acute demyelinating lesions

Jane A. Burnham, MD, PhD, Roy R. Wright, MD, James Dreisbach, MD and Ronald S. Murray, MD

Rocky Mountain Multiple Sclerosis Center (Dr. Murray), Colorado Neurological Institute (Drs. Burnham, Wright, Dreisbach, and Murray), and Swedish Medical Center (Drs. Burnham, Wright, Dreisbach, and Murray), Englewood, CO; and University of Colorado School of Medicine (Dr. Wright), Denver, CO.

Gadolinium (Gd) enhancement of brain lesions by MRI is a marker of active blood-brain barrier damage secondary to an inflammatory process. We studied the effects of high-dose (1,000 mg/d) intravenous (IV) methylprednisolone (Mp) for 4 to 8 days on Gd-enhancing lesions in seven patients with acute demyelinating diseases and compared pretreatment brain MRIs with studies obtained 1 to 4 days after treatment. Five patients had complete suppression, and two had significant suppression of Gd enhancement following treatment. In addition, six of seven patients had Gd-enhancing lesions that explained their clinical signs; in five of six of these patients, suppression of the Gd-enhanced lesions temporally correlated with clinical improvement. Thus, short courses of high-dose IV Mp suppress Gd enhancement in acute demyelinating lesions, and this correlates with clinical improvement.

Address correspondence and reprint requests to Dr. Jane A. Burnham, Colorado Neurological Services, P.C., 2480 S. Downing Street, Suite 250, Denver, CO 80210.

Received December 28, 1990. Accepted for publication in final form February 12, 1991.




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