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Corticosteroid treatment has been associated with prolonged remissions in chronic idiopathic relapsing polyneuritis (IRP).1-4 Recently, it has been noted that this response may require prolonged therapy,2 but can be maintained with alternate-day corticosteroid administration.3 Some authors have not noted a beneficial effect5 or have noted a worsening with corticosteroid therapy.4.6 The possibility that an initial worsening might precede improvement has not been considered.
We have treated a man with IRP whose initial response to corticosteroids was a dramatic worsening on each of four occasions. Although this
Griggs RC, Nash R. Diphasic Response to Corticosteroids in Idiopathic Relapsing Polyneuropathy. Arch Neurol. 1976;33(11):794–795. doi:10.1001/archneur.1976.00500110062013
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