Glucocorticoids are the first-line therapy of many neurological disorders, with the treatment regimen varying across types and characteristics of neurological disorders. This article reviews the national and international guidelines and expert consensuses in the past decade on glucocorticoids treatment for neurological disorders, and summarizes recommendations from the latest Chinese guidelines and consensuses. In summary, the most frequently used pulse therapy of glucocorticoids in China is intravenous infusion of high-dose (usually 1000 mg/d) methylprednisolone in a short period (often <5 d), followed by gradual tapering, bridging with oral prednisone or direct discontinuation. The treatment regimen for children and juveniles is similar to that for adults but the dose is adjusted by body weight. Pharmacodynamics of glucocorticoids should be considered for the treatment of perinatal women. To provide appropriate glucocorticoids treatment for patients with neurological disorders, clinicians should fully understand features of each neurological disorder and clinical characteristics of individual patient.
Citation: LIU Meng, WU Simiao. Guideline-recommended application of glucocorticoid in neurological disorders. West China Medical Journal, 2022, 37(12): 1891-1898. doi: 10.7507/1002-0179.202205015 Copy
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- 27. Sellner J, Boggild M, Clanet M, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol, 2010, 17(8): 1019-1032.
- 28. Sahraian MA, Moghadasi AN, Azimi AR, et al. Diagnosis and management of neuromyelitis optica spectrum disorder (NMOSD) in Iran: a consensus guideline and recommendations. Mult Scler Relat Disord, 2017, 18: 144-151.
- 29. Trebst C, Jarius S, Berthele A, et al. Update on the diagnosis and treatment of neuromyelitis optica: recommendations of the Neuromyelitis Optica Study Group (NEMOS). J Neurol, 2014, 261(1): 1-16.
- 30. Yamasaki R, Matsushita T, Fukazawa T, et al. Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica. Mult Scler, 2016, 22(10): 1337-1348.
- 31. 中国免疫学会神经免疫分会. 抗髓鞘少突胶质细胞糖蛋白免疫球蛋白 G 抗体相关疾病诊断和治疗中国专家共识. 中国神经免疫学和神经病学杂志, 2020, 27(2): 86-95.
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- 35. 中华医学会神经病学分会, 中华医学会神经病学分会周围神经病协作组, 中华医学会神经病学分会肌电图与临床神经电生理学组, 等. 中国慢性炎性脱髓鞘性多发性神经根神经病诊治指南 2019. 中华神经科杂志, 2019, 52(11): 883-888.
- 36. van den Bergh PYK, van Doorn PA, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force-second revision. J Peripher Nerv Syst, 2021, 26(3): 242-268.
- 37. 中华医学会神经病学分会, 中华医学会神经病学分会周围神经病协作组, 中华医学会神经病学分会肌电图与临床神经电生理学组, 等. 中国吉兰-巴雷综合征诊治指南 2019. 中华神经科杂志, 2019, 52(11): 877-882.
- 38. Leonhard SE, Mandarakas MR, Gondim F, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol, 2019, 15(11): 671-683.
- 39. Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome. Lancet, 2016, 388(10045): 717-727.
- 40. Korinthenberg R, Trollmann R, Felderhoff-Müser U, et al. Diagnosis and treatment of Guillain-Barré syndrome in childhood and adolescence: an evidence- and consensus-based guideline. Eur J Paediatr Neurol, 2020, 25: 5-16.
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- 42. Fieux M, Franco-Vidal V, Devic P, et al. French Society of ENT (SFORL) guidelines. Management of acute Bell’s palsy. Eur Ann Otorhinolaryngol Head Neck Dis, 2020, 137(6): 483-488.
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