As noted previously, it is common practice to employ a short course of corticosteroids to treat acute relapses of MS. Of the various approaches applied, the administration of IV methylprednisolone (IVMP) has become the most popular, especially because it can be given as a short course (typically 3–5 days), has a rapid onset of action, and is associated with relatively few side effects. Its use is now common practice in many clinics and hospitals on an outpatient basis. It should be given only under medical supervision because side-effects, even though extremely rare, include psychosis, peptic ulceration, aseptic bone necrosis, infections, cardiac arrhythmias, and thrombo-embolism.

Some neurologists also employ periodic pulses of IVMP (e.g. once monthly) in patients with progressive MS, but there is no firm evidence that this has a favourable impact on the course of the disease, and there is an increased risk of side-effects.

In the opinion of the Committee, a course of corticosteroids can be recommended for patients with exacerbations who have significant functional impact. Long-term use may be associated with significant serious side-effects.