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High-dose methylprednisolone may cause myopathy in acute spinal cord injury patients

T Qian1, X Guo, A D Levi

  • 1Department of Physical Medicine & Rehabilitation, University of Miami School of Medicine, FL 33125, USA.

Spinal Cord
|November 10, 2004
PubMed
Abstract

Insights

High-dose methylprednisolone (MP) for spinal cord injury (SCI) may cause acute corticosteroid myopathy (ACM). This muscle damage, not neuroprotection, might explain some observed neurological recovery in SCI patients treated with MP.

Area of Science:

  • Neurology
  • Pathology

Background:

  • High-dose intravenous methylprednisolone (MP) is a common treatment for spinal cord injury (SCI).
  • Recent studies challenge the neuroprotective benefits of MP in SCI.
  • The potential for MP to induce acute corticosteroid myopathy (ACM) requires investigation.

Purpose of the Study:

  • To test the hypothesis that MP administration can lead to ACM in SCI patients.
  • To evaluate muscle changes in SCI patients treated with MP compared to those not treated.

Main Methods:

  • Prospective cohort study involving SCI patients.
  • Comparison of five SCI patients receiving 24-hour MP infusion with three SCI patients not receiving MP.
  • Muscle biopsies and electromyography (EMG) were used to assess myopathic changes.

Main Results:

  • Four out of five MP-treated SCI patients showed muscle damage consistent with ACM on biopsy.
  • EMG studies confirmed myopathic changes in MP-treated patients.
  • SCI patients who did not receive MP had normal muscle biopsies and EMG results.

Conclusions:

  • MP, at the dose recommended by the National Acute Spinal Cord Injury Studies (NASCIS), may induce ACM.
  • Observed neurological recovery in NASCIS trials might be partly attributed to ACM recovery rather than MP's neuroprotective effects.

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