Report Steroid burst. in PANS / PANDAS (Lyme included) Posted April 27, 2011 What can I expect to see with this burst? Is there die off. Will she look really bad b4 she starts to look good? She goes wild and crazy with most meds. so I want to b prepared. He prescribed 40mg. for 6 days. At first I thought he said she would do something that would taper off each day. what is the usual dose?