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Relapse Management

Relapse Management

High dose steroids, Methylprednisolone is usually given during a relapse. Steroids work by dampening the immune system and reducing inflammation around the site of nerve damage. They are given:

• Intravenously 1g daily for 5-7 days or
• Orally 500mg-2g daily for 5-7 days,
• In combination of intravenous and oral, followed by
• A tapering course of oral steroids over several months.

If steroids don’t help, what next?

When attacks progress or do not respond to corticosteroid treatment, there are two further options, Plasma Exchange or Intravenous Immunoglobulins.

Immunosuppressants are used to dampen down the activity of the body’s immune system. Drugs such as Prednisolone, Azathioprine, Methotrexate or Mycophenolate are used to allow reduction of steroids. All these treatments increase the risk of serious infections therefore blood should be monitored for full blood count, kidney and liver function.

Rituximab may be considered if first line treatment has failed ie the patient had a further relapse.