The Nice Guidelines Oct 2014, suggest to offer treatment for relapse of MS with oral methylprednisolone g daily for 5 days and to consider intravenous methylprednisolone 1 g daily for 3-5 days as an alternative for people with MS in whom oral steroids have failed or not been tolerated or those who need admitting to hospital for a severe relapse or monitoring of medical or psychological conditions such as diabetes or depression.

Prior to treatment infection should be excluded as the reason for deterioration (pseudo-relapse). Steroids have an immunosuppressant action and exacerbate infection.

https://www.nice.org.uk/guidance/cg186/chapter/1-recommendations#relapse-and-exacerbation. Accessed 21^st July 2017.

Effects of Steroids

• Reduce inflammation.
• Shortens the duration of the relapse.
• Speed up recovery from a relapse.

Steroids Do NOT:

• Reverse the outcome of a relapse.
• This means that whatever disability results from a relapse that disability will still occur irrespective of whether treatment has been taken.

It is not advised to take more than two courses of per year, unless you are having a number of disabling relapses. If there is a slow response from one course of steroids, another course may be necessary.

(MS Ireland, 2010 Steroid Information Leaflet)

http://www.ms-society.ie/uploads/File/Living%20with%20MS/MS%20Steroids_Info%20Sheet%202010%20_2_.pdf {Accessed 21^st July 2017}