• Administration of methylprednisolone (MP)for the treatment of acute spinal cord injury(SCI) is not recommended. Clinicians considering MP therapy should bear in mind that the drug is not Food and Drug Administration (FDA) approved for this application. There is no Class I or Class II medicalevidence supporting the clinical benefit of MP in the treatment of acute SCI. Scatteredreports of Class III evidence claim inconsistent effects likely related to random chance or selection bias. However, Class I, II, and IIIevidence exists that high-dose steroids areassociated with harmful side effects including death.

• Administration of GM-1 ganglioside (Sygen) for the treatment of acute SCI is not recommended.