الفهرس 
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Abstract
Background: The study investigated the relationship between random blood sugar (RBS) levels
and clinical outcomes in patients with relapsing-remitting multiple sclerosis (RRMS) following
intravenous methylprednisolone (IVMP) treatment.
Objective: Determine the relationship between blood glucose level during intravenous
methylprednisolone (IVMP) treatment and the degree of motor & cognitive recovery afterwards in
relapsing remitting multiple sclerosis patient.
Subjects and Methods: This observational analytical prospective study was conducted on 40
patients with relapsing remitting multiple sclerosis (RRMS) at Nasr city hospital of health insurance
– Ain Shams University Hospital between May 2022 and November 2022. The study population
was adults with confirmed diagnosis of relapsing-remitting multiple sclerosis who are currently
experiencing a relapse. Patients with other neurological diseases, cognitive disorders, diabetes,
certain medications, learning disabilities, or who are pregnant or using hormone replacement
therapy are excluded. The study tools for this study include a clinical assessment of MS patients, the
use of the Expanded Disability Status Scale (EDSS) to assess motor deficit, the use of the Symbol
Digit Modalities Test (SDMT) to assess cognitive function, and the measurement of fasting blood
glucose. The purpose of these study tools is to assess the effects of IVMP induced hyperglycemia
on motor & cognitive relapse recovery in relapsing remitting multiple sclerosis patients.
Results: The study sample included 40 patients with definite RRMS, and the primary outcome
measure was EDSS. The study found that hyperglycemia may be a potential predictor of poor
treatment response in MS patients. The study also identified cut-off values for RBS levels that can
predict the probability of recovery after IVMP treatment. The significant relationship between older
age of onset and poorer SDMT performance supports previous research that has found age to be a
risk factor for cognitive decline in MS. Similarly, the significant relationship between longer
duration of illness and poorer SDMT performance is consistent with previous studies that have
found disease duration to be a predictor of cognitive impairment in MS.
Conclusion: The present study provides further evidence of the association between hyperglycemia
and poor outcomes in patients with RRMS following IVMP treatment. The findings suggest that
RBS levels may be a useful prognostic marker for predicting cognitive and functional outcomes in
MS patients. Clinicians should consider monitoring and managing RBS levels in MS patients to
optimize treatment outcomes. However, further studies are needed to elucidate the underlying
mechanisms and to determine the optimal cut-off values for RBS levels in predicting MS outcomes.