Glucocorticoids are the first-line therapy of many neurological disorders, with the treatment regimen varying across types and characteristics of neurological disorders. This article reviews the national and international guidelines and expert consensuses in the past decade on glucocorticoids treatment for neurological disorders, and summarizes recommendations from the latest Chinese guidelines and consensuses. In summary, the most frequently used pulse therapy of glucocorticoids in China is intravenous infusion of high-dose (usually 1000 mg/d) methylprednisolone in a short period (often <5 d), followed by gradual tapering, bridging with oral prednisone or direct discontinuation. The treatment regimen for children and juveniles is similar to that for adults but the dose is adjusted by body weight. Pharmacodynamics of glucocorticoids should be considered for the treatment of perinatal women. To provide appropriate glucocorticoids treatment for patients with neurological disorders, clinicians should fully understand features of each neurological disorder and clinical characteristics of individual patient.
Citation： LIU Meng, WU Simiao. Guideline-recommended application of glucocorticoid in neurological disorders. West China Medical Journal, 2022, 37(12): 1891-1898. doi: 10.7507/1002-0179.202205015 Copy
| 1. | Vandewalle J, Luypaert A, De Bosscher K, et al. Therapeutic mechanisms of glucocorticoids. Trends Endocrinol Metab, 2018, 29(1): 42-54. |
| 2. | Galati A, Brown ES, Bove R, et al. Glucocorticoids for therapeutic immunosuppression: clinical pearls for the practicing neurologist. J Neurol Sci, 2021, 430: 120004. |
| 3. | 陈嘉欣, 冯慧宇. 重视常见神经免疫疾病激素冲击治疗和减量方案的规范性. 中华神经科杂志, 2021, 54(9): 876-884. |
| 4. | 宁光. 糖皮质激素类药物临床应用指导原则. 中华内分泌代谢杂志, 2012, 28(2): 171-202. |
| 5. | Prete A, Bancos I. Glucocorticoid induced adrenal insufficiency. BMJ, 2021, 374: n1380. |
| 6. | Nicolaides NC, Pavlaki AN, Maria Alexandra MA, et al. glucocorticoid therapy and adrenal suppression//Feingold KR, Anawalt B, Boyce A, et al. Endotext [Internet]. South Dartmouth (MA): MDText. com, Inc., 2000. |
| 7. | Buttgereit F, Brand MD, Burmester GR. Equivalent doses and relative drug potencies for non-genomic glucocorticoid effects: a novel glucocorticoid hierarchy. Biochem Pharmacol, 1999, 58(2): 363-368. |
| 8. | Buttgereit F, da Silva JAP, Boers M, et al. Standardised nomenclature for glucocorticoid dosages and glucocorticoid treatment regimens: current questions and tentative answers in rheumatology. Ann Rheum Dis, 2002, 61(8): 718-722. |
| 9. | Graus F, Titulaer MJ, Balu R, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol, 2016, 15(4): 391-404. |
| 10. | 中华医学会神经病学分会. 中国自身免疫性脑炎诊治专家共识. 中华神经科杂志, 2017, 50(2): 91-98. |
| 11. | Zuliani L, Nosadini M, Gastaldi M, et al. Management of antibody-mediated autoimmune encephalitis in adults and children: literature review and consensus-based practical recommendations. Neurol Sci, 2019, 40(10): 2017-2030. |
| 12. | Nosadini M, Thomas T, Eyre M, et al. International consensus recommendations for the treatment of pediatric NMDAR antibody encephalitis. Neurol Neuroimmunol Neuroinflamm, 2021, 8(5): e1052. |
| 13. | McCarthy A, Dineen J, McKenna P, et al. Anti-NMDA receptor encephalitis with associated catatonia during pregnancy. J Neurol, 2012, 259(12): 2632-2635. |
| 14. | 中国免疫学会神经免疫分会, 中华医学会神经病学分会神经免疫学组. 多发性硬化诊断和治疗中国专家共识(2018 版). 中国神经免疫学和神经病学杂志, 2018, 25(6): 387-394. |
| 15. | Filippini G, Brusaferri F, Sibley WA, et al. Corticosteroids or ACTH for acute exacerbations in multiple sclerosis. Cochrane Database Syst Rev, 2000(4): CD001331. |
| 16. | Yamout B, Sahraian M, Bohlega S, et al. Consensus recommendations for the diagnosis and treatment of multiple sclerosis: 2019 revisions to the MENACTRIMS guidelines. Mult Scler Relat Disord, 2020, 37: 101459. |
| 17. | Laplaud D, Bodiguel E, Bensa C, et al. Recommendations for the management of multiple sclerosis relapses. Rev Neurol (Paris), 2012, 168(5): 425-433. |
| 18. | Marques VD, Passos G, Mendes MF, et al. Brazilian consensus for the treatment of multiple sclerosis: Brazilian Academy of Neurology and Brazilian Committee on Treatment and Research in Multiple Sclerosis. Arq Neuropsiquiatr, 2018, 76(8): 539-554. |
| 19. | Shatila AR, Koussa S, Jabbour R, et al. LSN MS guidelines for the management of multiple sclerosis. Rev Neurol (Paris), 2013, 169(12): 950-955. |
| 20. | Huppke P, Gärtner J. A practical guide to pediatric multiple sclerosis. Neuropediatrics, 2010, 41(4): 157-162. |
| 21. | Ghezzi A, Banwell B, Boyko A, et al. The management of multiple sclerosis in children: a European view. Mult Scler, 2010, 16(10): 1258-1267. |
| 22. | Waldman AT, Gorman MP, Rensel MR, et al. Management of pediatric central nervous system demyelinating disorders: consensus of United States neurologists. J Child Neurol, 2011, 26(6): 675-682. |
| 23. | Liguori NF, Alonso R, Pinheiro AA, et al. Consensus recommendations for family planning and pregnancy in multiple sclerosis in argentina. Mult Scler Relat Disord, 2020, 43: 102147. |
| 24. | Dobson R, Dassan P, Roberts M, et al. UK consensus on pregnancy in multiple sclerosis: ‘Association of British Neurologists’ guidelines. Pract Neurol, 2019, 19(2): 106-114. |
| 25. | 中国免疫学会神经免疫分会. 中国视神经脊髓炎谱系疾病诊断与治疗指南(2021 版). 中国神经免疫学和神经病学杂志, 2021, 28(6): 423-436. |
| 26. | Carnero Contentti E, Rojas JI, Cristiano E, et al. Latin American consensus recommendations for management and treatment of neuromyelitis optica spectrum disorders in clinical practice. Mult Scler Relat Disord, 2020, 45: 102428. |
| 27. | Sellner J, Boggild M, Clanet M, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol, 2010, 17(8): 1019-1032. |
| 28. | Sahraian MA, Moghadasi AN, Azimi AR, et al. Diagnosis and management of neuromyelitis optica spectrum disorder (NMOSD) in Iran: a consensus guideline and recommendations. Mult Scler Relat Disord, 2017, 18: 144-151. |
| 29. | Trebst C, Jarius S, Berthele A, et al. Update on the diagnosis and treatment of neuromyelitis optica: recommendations of the Neuromyelitis Optica Study Group (NEMOS). J Neurol, 2014, 261(1): 1-16. |
| 30. | Yamasaki R, Matsushita T, Fukazawa T, et al. Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica. Mult Scler, 2016, 22(10): 1337-1348. |
| 31. | 中国免疫学会神经免疫分会. 抗髓鞘少突胶质细胞糖蛋白免疫球蛋白 G 抗体相关疾病诊断和治疗中国专家共识. 中国神经免疫学和神经病学杂志, 2020, 27(2): 86-95. |
| 32. | Bruijstens AL, Wendel EM, Lechner C, et al. E. U. paediatric MOG consortium consensus: Part 5 - Treatment of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders . Eur J Paediatr Neurol, 2020, 29: 41-53. |
| 33. | 贾建平, 陈生弟. 神经病学. 北京: 人民卫生出版社, 2015: 324. |
| 34. | Scott TF, Frohman EM, De Seze J, et al. Evidence-based guideline: clinical evaluation and treatment of transverse myelitis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 2011, 77(24): 2128-2134. |
| 35. | 中华医学会神经病学分会, 中华医学会神经病学分会周围神经病协作组, 中华医学会神经病学分会肌电图与临床神经电生理学组, 等. 中国慢性炎性脱髓鞘性多发性神经根神经病诊治指南 2019. 中华神经科杂志, 2019, 52(11): 883-888. |
| 36. | van den Bergh PYK, van Doorn PA, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force-second revision. J Peripher Nerv Syst, 2021, 26(3): 242-268. |
| 37. | 中华医学会神经病学分会, 中华医学会神经病学分会周围神经病协作组, 中华医学会神经病学分会肌电图与临床神经电生理学组, 等. 中国吉兰-巴雷综合征诊治指南 2019. 中华神经科杂志, 2019, 52(11): 877-882. |
| 38. | Leonhard SE, Mandarakas MR, Gondim F, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol, 2019, 15(11): 671-683. |
| 39. | Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome. Lancet, 2016, 388(10045): 717-727. |
| 40. | Korinthenberg R, Trollmann R, Felderhoff-Müser U, et al. Diagnosis and treatment of Guillain-Barré syndrome in childhood and adolescence: an evidence- and consensus-based guideline. Eur J Paediatr Neurol, 2020, 25: 5-16. |
| 41. | 中华医学会神经病学分会, 中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图与临床神经电生理学组. 中国特发性面神经麻痹诊治指南. 中华神经科杂志, 2016(2): 84-86. |
| 42. | Fieux M, Franco-Vidal V, Devic P, et al. French Society of ENT (SFORL) guidelines. Management of acute Bell’s palsy. Eur Ann Otorhinolaryngol Head Neck Dis, 2020, 137(6): 483-488. |
| 43. | De Almeida JR, Guyatt GH, Sud S, et al. Management of Bell palsy: clinical practice guideline. CMAJ, 2014, 186(12): 917-922. |
| 44. | Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell’s palsy executive summary. Otolaryngol Head Neck Surg, 2013, 149(5): 656-663. |
| 45. | Gronseth GS, Paduga R, American Academy of Neurology. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 2012, 79(22): 2209-2213. |
| 46. | 中华医学会神经病学分会神经免疫学组, 中国免疫学会神经免疫学分会. 中国重症肌无力诊断和治疗指南 2015. 中华神经科杂志, 2015, 48(11): 934-940. |
| 47. | 中国免疫学会神经免疫分会. 中国重症肌无力诊断和治疗指南(2020 版). 中国神经免疫学和神经病学杂志, 2021, 28(1): 1-12. |
| 48. | Nafissi S, Okhovat AA, Sinaei F, et al. Iranian consensus recommendations for treatment of myasthenia gravis. Arch Iran Med, 2022, 25(1): 37-49. |
| 49. | Evoli A, Antonini G, Antozzi C, et al. Italian recommendations for the diagnosis and treatment of myasthenia gravis. Neurol Sci, 2019, 40(6): 1111-1124. |
| 50. | Sanders DB, Wolfe GI, Benatar M, et al. International consensus guidance for management of myasthenia gravis: Executive summary. Neurology, 2016, 87(4): 419-425. |
| 51. | Sussman J, Farrugia ME, Maddison P, et al. Myasthenia gravis: Association of British Neurologists’ management guidelines. Pract Neurol, 2015, 15(3): 199-206. |
| 52. | Skeie GO, Apostolski S, Evoli A, et al. Guidelines for treatment of autoimmune neuromuscular transmission disorders. Eur J Neurol, 2010, 17(7): 893-902. |
| 53. | Melzer N, Ruck T, Fuhr P, et al. Clinical features, pathogenesis, and treatment of myasthenia gravis: a supplement to the Guidelines of the German Neurological Society. J Neurol, 2016, 263(8): 1473-1494. |
| 54. | Narayanaswami P, Sanders DB, Wolfe G, et al. International consensus guidance for management of myasthenia gravis: 2020 update. Neurology, 2021, 96(3): 114-122. |
| 55. | Kerty E, Elsais A, Argov Z, et al. EFNS/ENS Guidelines for the treatment of ocular myasthenia. Eur J Neurol, 2014, 21(5): 687-693. |
| 56. | Murai H. Japanese clinical guidelines for myasthenia gravis: putting into practice. Clin Exp Neuroimmunol, 2015, 6(1): 21-31. |
| 57. | Kadota Y, Horio H, Mori T, et al. Perioperative management in myasthenia gravis: republication of a systematic review and a proposal by the guideline committee of the Japanese Association for Chest Surgery 2014. Gen Thorac Cardiovasc Surg, 2015, 63(4): 201-215. |
| 58. | Munot P, Robb SA, Niks EH, et al. 242nd ENMC International Workshop: diagnosis and management of juvenile myasthenia gravis Hoofddorp, the Netherlands, 1-3 March 2019. Neuromuscul Disord, 2020, 30(3): 254-264. |
| 59. | 中华医学会神经病学分会, 中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图及临床神经生理学组. 中国多发性肌炎诊治共识. 中华神经科杂志, 2015, 48(11): 946-949. |
| 60. | Kohsaka H, Mimori T, Kanda T, et al. Treatment consensus for management of polymyositis and dermatomyositis among rheumatologists, neurologists and dermatologists. Mod Rheumatol, 2019, 29(1): 1-19. |
| 61. | 中华医学会神经病学分会, 中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图与临床神经生理学组. 中国假肥大型肌营养不良症诊治指南. 中华神经科杂志, 2016, 49(1): 17-20. |
| 62. | 中华医学会医学遗传学分会遗传病临床实践指南撰写组. 杜氏进行性肌营养不良的临床实践指南. 中华医学遗传学杂志, 2020, 37(3): 258-262. |
| 63. | 中国免疫学会神经免疫学分会, 中华医学会神经病学分会神经免疫学组, 中国医师协会神经内科医师分会神经免疫专员委业会. 原发性中枢神经系统血管炎诊断和治疗中国专家共识. 中国神经免疫学和神经病学杂志, 2017, 24(4): 229-239. |
| 64. | Beuker C, Strunk D, Rawal R, et al. Primary angiitis of the CNS: a systematic review and meta-analysis. Neurol Neuroimmunol Neuroinflamm, 2021, 8(6): e1093. |
| 65. | Beelen J, Benseler SM, Dropol A, et al. Strategies for treatment of childhood primary angiitis of the central nervous system. Neurol Neuroimmunol Neuroinflamm, 2019, 6(4): e567. |
| 66. | Sandercock PA, Soane T. Corticosteroids for acute ischaemic stroke. Cochrane Database Syst Rev, 2011(9): CD000064. |
| 67. | 吴思缈, 吴波, 郭富强, 等. 重症脑梗死优化诊治方案及流程建议草案. 华西医学, 2019, 34(10): 1096-1108. |
| 68. | Torbey MT, Bösel J, Rhoney DH, et al. Evidence-based guidelines for the management of large hemispheric infarction: a statement for health care professionals from the Neurocritical Care Society and the German Society for Neuro-intensive Care and Emergency Medicine. Neurocrit Care, 2015, 22(1): 146-164. |
| 69. | Wijdicks EFM, Sheth KN, Carter BS, et al. Recommendations for the management of cerebral and cerebellar infarction with swelling: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2014, 45(4): 1222-1238. |
| 70. | van der Worp HB, Hofmeijer J, Jüttler E, et al. European Stroke Organisation (ESO) guidelines on the management of space-occupying brain infarction. Eur Stroke J, 2021, 6(2): XC-CX. |
- 1. Vandewalle J, Luypaert A, De Bosscher K, et al. Therapeutic mechanisms of glucocorticoids. Trends Endocrinol Metab, 2018, 29(1): 42-54.
- 2. Galati A, Brown ES, Bove R, et al. Glucocorticoids for therapeutic immunosuppression: clinical pearls for the practicing neurologist. J Neurol Sci, 2021, 430: 120004.
- 3. 陈嘉欣, 冯慧宇. 重视常见神经免疫疾病激素冲击治疗和减量方案的规范性. 中华神经科杂志, 2021, 54(9): 876-884.
- 4. 宁光. 糖皮质激素类药物临床应用指导原则. 中华内分泌代谢杂志, 2012, 28(2): 171-202.
- 5. Prete A, Bancos I. Glucocorticoid induced adrenal insufficiency. BMJ, 2021, 374: n1380.
- 6. Nicolaides NC, Pavlaki AN, Maria Alexandra MA, et al. glucocorticoid therapy and adrenal suppression//Feingold KR, Anawalt B, Boyce A, et al. Endotext [Internet]. South Dartmouth (MA): MDText. com, Inc., 2000.
- 7. Buttgereit F, Brand MD, Burmester GR. Equivalent doses and relative drug potencies for non-genomic glucocorticoid effects: a novel glucocorticoid hierarchy. Biochem Pharmacol, 1999, 58(2): 363-368.
- 8. Buttgereit F, da Silva JAP, Boers M, et al. Standardised nomenclature for glucocorticoid dosages and glucocorticoid treatment regimens: current questions and tentative answers in rheumatology. Ann Rheum Dis, 2002, 61(8): 718-722.
- 9. Graus F, Titulaer MJ, Balu R, et al. A clinical approach to diagnosis of autoimmune encephalitis. Lancet Neurol, 2016, 15(4): 391-404.
- 10. 中华医学会神经病学分会. 中国自身免疫性脑炎诊治专家共识. 中华神经科杂志, 2017, 50(2): 91-98.
- 11. Zuliani L, Nosadini M, Gastaldi M, et al. Management of antibody-mediated autoimmune encephalitis in adults and children: literature review and consensus-based practical recommendations. Neurol Sci, 2019, 40(10): 2017-2030.
- 12. Nosadini M, Thomas T, Eyre M, et al. International consensus recommendations for the treatment of pediatric NMDAR antibody encephalitis. Neurol Neuroimmunol Neuroinflamm, 2021, 8(5): e1052.
- 13. McCarthy A, Dineen J, McKenna P, et al. Anti-NMDA receptor encephalitis with associated catatonia during pregnancy. J Neurol, 2012, 259(12): 2632-2635.
- 14. 中国免疫学会神经免疫分会, 中华医学会神经病学分会神经免疫学组. 多发性硬化诊断和治疗中国专家共识(2018 版). 中国神经免疫学和神经病学杂志, 2018, 25(6): 387-394.
- 15. Filippini G, Brusaferri F, Sibley WA, et al. Corticosteroids or ACTH for acute exacerbations in multiple sclerosis. Cochrane Database Syst Rev, 2000(4): CD001331.
- 16. Yamout B, Sahraian M, Bohlega S, et al. Consensus recommendations for the diagnosis and treatment of multiple sclerosis: 2019 revisions to the MENACTRIMS guidelines. Mult Scler Relat Disord, 2020, 37: 101459.
- 17. Laplaud D, Bodiguel E, Bensa C, et al. Recommendations for the management of multiple sclerosis relapses. Rev Neurol (Paris), 2012, 168(5): 425-433.
- 18. Marques VD, Passos G, Mendes MF, et al. Brazilian consensus for the treatment of multiple sclerosis: Brazilian Academy of Neurology and Brazilian Committee on Treatment and Research in Multiple Sclerosis. Arq Neuropsiquiatr, 2018, 76(8): 539-554.
- 19. Shatila AR, Koussa S, Jabbour R, et al. LSN MS guidelines for the management of multiple sclerosis. Rev Neurol (Paris), 2013, 169(12): 950-955.
- 20. Huppke P, Gärtner J. A practical guide to pediatric multiple sclerosis. Neuropediatrics, 2010, 41(4): 157-162.
- 21. Ghezzi A, Banwell B, Boyko A, et al. The management of multiple sclerosis in children: a European view. Mult Scler, 2010, 16(10): 1258-1267.
- 22. Waldman AT, Gorman MP, Rensel MR, et al. Management of pediatric central nervous system demyelinating disorders: consensus of United States neurologists. J Child Neurol, 2011, 26(6): 675-682.
- 23. Liguori NF, Alonso R, Pinheiro AA, et al. Consensus recommendations for family planning and pregnancy in multiple sclerosis in argentina. Mult Scler Relat Disord, 2020, 43: 102147.
- 24. Dobson R, Dassan P, Roberts M, et al. UK consensus on pregnancy in multiple sclerosis: ‘Association of British Neurologists’ guidelines. Pract Neurol, 2019, 19(2): 106-114.
- 25. 中国免疫学会神经免疫分会. 中国视神经脊髓炎谱系疾病诊断与治疗指南(2021 版). 中国神经免疫学和神经病学杂志, 2021, 28(6): 423-436.
- 26. Carnero Contentti E, Rojas JI, Cristiano E, et al. Latin American consensus recommendations for management and treatment of neuromyelitis optica spectrum disorders in clinical practice. Mult Scler Relat Disord, 2020, 45: 102428.
- 27. Sellner J, Boggild M, Clanet M, et al. EFNS guidelines on diagnosis and management of neuromyelitis optica. Eur J Neurol, 2010, 17(8): 1019-1032.
- 28. Sahraian MA, Moghadasi AN, Azimi AR, et al. Diagnosis and management of neuromyelitis optica spectrum disorder (NMOSD) in Iran: a consensus guideline and recommendations. Mult Scler Relat Disord, 2017, 18: 144-151.
- 29. Trebst C, Jarius S, Berthele A, et al. Update on the diagnosis and treatment of neuromyelitis optica: recommendations of the Neuromyelitis Optica Study Group (NEMOS). J Neurol, 2014, 261(1): 1-16.
- 30. Yamasaki R, Matsushita T, Fukazawa T, et al. Efficacy of intravenous methylprednisolone pulse therapy in patients with multiple sclerosis and neuromyelitis optica. Mult Scler, 2016, 22(10): 1337-1348.
- 31. 中国免疫学会神经免疫分会. 抗髓鞘少突胶质细胞糖蛋白免疫球蛋白 G 抗体相关疾病诊断和治疗中国专家共识. 中国神经免疫学和神经病学杂志, 2020, 27(2): 86-95.
- 32. Bruijstens AL, Wendel EM, Lechner C, et al. E. U. paediatric MOG consortium consensus: Part 5 - Treatment of paediatric myelin oligodendrocyte glycoprotein antibody-associated disorders . Eur J Paediatr Neurol, 2020, 29: 41-53.
- 33. 贾建平, 陈生弟. 神经病学. 北京: 人民卫生出版社, 2015: 324.
- 34. Scott TF, Frohman EM, De Seze J, et al. Evidence-based guideline: clinical evaluation and treatment of transverse myelitis: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology. Neurology, 2011, 77(24): 2128-2134.
- 35. 中华医学会神经病学分会, 中华医学会神经病学分会周围神经病协作组, 中华医学会神经病学分会肌电图与临床神经电生理学组, 等. 中国慢性炎性脱髓鞘性多发性神经根神经病诊治指南 2019. 中华神经科杂志, 2019, 52(11): 883-888.
- 36. van den Bergh PYK, van Doorn PA, Hadden RDM, et al. European Academy of Neurology/Peripheral Nerve Society guideline on diagnosis and treatment of chronic inflammatory demyelinating polyradiculoneuropathy: report of a joint task force-second revision. J Peripher Nerv Syst, 2021, 26(3): 242-268.
- 37. 中华医学会神经病学分会, 中华医学会神经病学分会周围神经病协作组, 中华医学会神经病学分会肌电图与临床神经电生理学组, 等. 中国吉兰-巴雷综合征诊治指南 2019. 中华神经科杂志, 2019, 52(11): 877-882.
- 38. Leonhard SE, Mandarakas MR, Gondim F, et al. Diagnosis and management of Guillain-Barré syndrome in ten steps. Nat Rev Neurol, 2019, 15(11): 671-683.
- 39. Willison HJ, Jacobs BC, van Doorn PA. Guillain-Barré syndrome. Lancet, 2016, 388(10045): 717-727.
- 40. Korinthenberg R, Trollmann R, Felderhoff-Müser U, et al. Diagnosis and treatment of Guillain-Barré syndrome in childhood and adolescence: an evidence- and consensus-based guideline. Eur J Paediatr Neurol, 2020, 25: 5-16.
- 41. 中华医学会神经病学分会, 中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图与临床神经电生理学组. 中国特发性面神经麻痹诊治指南. 中华神经科杂志, 2016(2): 84-86.
- 42. Fieux M, Franco-Vidal V, Devic P, et al. French Society of ENT (SFORL) guidelines. Management of acute Bell’s palsy. Eur Ann Otorhinolaryngol Head Neck Dis, 2020, 137(6): 483-488.
- 43. De Almeida JR, Guyatt GH, Sud S, et al. Management of Bell palsy: clinical practice guideline. CMAJ, 2014, 186(12): 917-922.
- 44. Baugh RF, Basura GJ, Ishii LE, et al. Clinical practice guideline: Bell’s palsy executive summary. Otolaryngol Head Neck Surg, 2013, 149(5): 656-663.
- 45. Gronseth GS, Paduga R, American Academy of Neurology. Evidence-based guideline update: steroids and antivirals for Bell palsy: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology, 2012, 79(22): 2209-2213.
- 46. 中华医学会神经病学分会神经免疫学组, 中国免疫学会神经免疫学分会. 中国重症肌无力诊断和治疗指南 2015. 中华神经科杂志, 2015, 48(11): 934-940.
- 47. 中国免疫学会神经免疫分会. 中国重症肌无力诊断和治疗指南(2020 版). 中国神经免疫学和神经病学杂志, 2021, 28(1): 1-12.
- 48. Nafissi S, Okhovat AA, Sinaei F, et al. Iranian consensus recommendations for treatment of myasthenia gravis. Arch Iran Med, 2022, 25(1): 37-49.
- 49. Evoli A, Antonini G, Antozzi C, et al. Italian recommendations for the diagnosis and treatment of myasthenia gravis. Neurol Sci, 2019, 40(6): 1111-1124.
- 50. Sanders DB, Wolfe GI, Benatar M, et al. International consensus guidance for management of myasthenia gravis: Executive summary. Neurology, 2016, 87(4): 419-425.
- 51. Sussman J, Farrugia ME, Maddison P, et al. Myasthenia gravis: Association of British Neurologists’ management guidelines. Pract Neurol, 2015, 15(3): 199-206.
- 52. Skeie GO, Apostolski S, Evoli A, et al. Guidelines for treatment of autoimmune neuromuscular transmission disorders. Eur J Neurol, 2010, 17(7): 893-902.
- 53. Melzer N, Ruck T, Fuhr P, et al. Clinical features, pathogenesis, and treatment of myasthenia gravis: a supplement to the Guidelines of the German Neurological Society. J Neurol, 2016, 263(8): 1473-1494.
- 54. Narayanaswami P, Sanders DB, Wolfe G, et al. International consensus guidance for management of myasthenia gravis: 2020 update. Neurology, 2021, 96(3): 114-122.
- 55. Kerty E, Elsais A, Argov Z, et al. EFNS/ENS Guidelines for the treatment of ocular myasthenia. Eur J Neurol, 2014, 21(5): 687-693.
- 56. Murai H. Japanese clinical guidelines for myasthenia gravis: putting into practice. Clin Exp Neuroimmunol, 2015, 6(1): 21-31.
- 57. Kadota Y, Horio H, Mori T, et al. Perioperative management in myasthenia gravis: republication of a systematic review and a proposal by the guideline committee of the Japanese Association for Chest Surgery 2014. Gen Thorac Cardiovasc Surg, 2015, 63(4): 201-215.
- 58. Munot P, Robb SA, Niks EH, et al. 242nd ENMC International Workshop: diagnosis and management of juvenile myasthenia gravis Hoofddorp, the Netherlands, 1-3 March 2019. Neuromuscul Disord, 2020, 30(3): 254-264.
- 59. 中华医学会神经病学分会, 中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图及临床神经生理学组. 中国多发性肌炎诊治共识. 中华神经科杂志, 2015, 48(11): 946-949.
- 60. Kohsaka H, Mimori T, Kanda T, et al. Treatment consensus for management of polymyositis and dermatomyositis among rheumatologists, neurologists and dermatologists. Mod Rheumatol, 2019, 29(1): 1-19.
- 61. 中华医学会神经病学分会, 中华医学会神经病学分会神经肌肉病学组, 中华医学会神经病学分会肌电图与临床神经生理学组. 中国假肥大型肌营养不良症诊治指南. 中华神经科杂志, 2016, 49(1): 17-20.
- 62. 中华医学会医学遗传学分会遗传病临床实践指南撰写组. 杜氏进行性肌营养不良的临床实践指南. 中华医学遗传学杂志, 2020, 37(3): 258-262.
- 63. 中国免疫学会神经免疫学分会, 中华医学会神经病学分会神经免疫学组, 中国医师协会神经内科医师分会神经免疫专员委业会. 原发性中枢神经系统血管炎诊断和治疗中国专家共识. 中国神经免疫学和神经病学杂志, 2017, 24(4): 229-239.
- 64. Beuker C, Strunk D, Rawal R, et al. Primary angiitis of the CNS: a systematic review and meta-analysis. Neurol Neuroimmunol Neuroinflamm, 2021, 8(6): e1093.
- 65. Beelen J, Benseler SM, Dropol A, et al. Strategies for treatment of childhood primary angiitis of the central nervous system. Neurol Neuroimmunol Neuroinflamm, 2019, 6(4): e567.
- 66. Sandercock PA, Soane T. Corticosteroids for acute ischaemic stroke. Cochrane Database Syst Rev, 2011(9): CD000064.
- 67. 吴思缈, 吴波, 郭富强, 等. 重症脑梗死优化诊治方案及流程建议草案. 华西医学, 2019, 34(10): 1096-1108.
- 68. Torbey MT, Bösel J, Rhoney DH, et al. Evidence-based guidelines for the management of large hemispheric infarction: a statement for health care professionals from the Neurocritical Care Society and the German Society for Neuro-intensive Care and Emergency Medicine. Neurocrit Care, 2015, 22(1): 146-164.
- 69. Wijdicks EFM, Sheth KN, Carter BS, et al. Recommendations for the management of cerebral and cerebellar infarction with swelling: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 2014, 45(4): 1222-1238.
- 70. van der Worp HB, Hofmeijer J, Jüttler E, et al. European Stroke Organisation (ESO) guidelines on the management of space-occupying brain infarction. Eur Stroke J, 2021, 6(2): XC-CX.