Management of acute multiple sclerosis by a long acting intrathecally administered corticosteroid

There are a number of relative or absolute contra-indications to the conventional cortisone therapy of the acute episode of multiple sclerosis. Furthermore, chronic progressive spinal types of MS present a particular therapeutic problem. As an alternative to systemic corticosteroid therapy, intrathecal application of a depot corticosteroid is available. The advantage of this treatment and controversial opinions are discussed. In contrast to systemic application, our own investigations of the endogenous serum Cortisol levels after a single administration of 40 mg triamcinolone acetonide revealed no suggestion of suppression of the suprarenal cortex. Clinical application showed good tolerance with a satisfactory therapeutic action.