Methylprednisolone May Worsen Muscle Atrophy In Spinal Cord Injury

A brief, high dose treatment of methylprednisolone within the first 8 hours of a spinal cord injury has been associated with improved functional outcome, and has therefore become a routine treatment. However, methylprednisolone is also related to adverse effects on skeletal muscle and the immune system. The treatment is consequently a controversial one-do the adverse effects outweigh the potential benefits?

A recent animal study found that a brief, high dose treatment of methylprednisolone caused profound muscle atrophy. This atrophy occurred not only in the paralyzed muscles, but also functionally intact muscle, which can impact the ability to use a wheelchair in the future. In addition, the study indicated a potential atrophy in respiratory muscles, which can impact independent ventilation.

While an animal study may not be completely related to human functioning, this study shows significant evidence that the benefits of routine methylprednisolone treatment may not outweigh its adverse effects.

Wu Y, Hou J, Collier L, et al. The administration of high-dose methylprednisolone for 24h reduced muscle size and increased atrophy-related gene expression in spinal cord-injured rats. Spinal Cord. (September 2011).

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