What is a Relapse?

The definition of an MS relapse (or exacerbation) is the sudden onset of new symptoms or worsened symptoms that last for more than 24 hours and is separated from a previous relapse by at least 30 days.  It can be very mild or severe enough to interfere with a person’s ability to function at home and at work. No two exacerbations are alike, and symptoms vary from person to person and often from one relapse to another.  A relapse results from inflammation in the central nervous system which damages the myelin and disrupts the transmission of nerve impulses.

“Most exacerbations last from a few days to several weeks or even months,” states the National Multiple Sclerosis Society.

But the presence of worsened symptoms does not always signal a new relapse, as there are many triggers that can lead to a reappearance of old MS symptoms or bring on new symptoms that mimic a relapse.    Read Part One and Part Two of Multiple Sclerosis Relapse or Pseudoexacerbation? for more information.

It is also possible to have symptoms which are due to an underlying medical condition, such as a thyroid problem, a vitamin deficiency, migraine headaches, or anemia, rather than MS---but it can be hard to tell the true cause.  For instance, you might think that vision changes are related to your MS, but in fact they may be caused by your migraines. 

What to Do If You Have a Relapse

The best thing you can do to manage your MS is to stay attuned to your body and become familiar with the pattern of your symptoms.  Call your MS clinician if you have new symptoms or an old symptom comes back and gets more severe over time--for instance, if you have tingling in your arm in the morning and by the next day one whole side of your body is tingling. 

Questions to Ask Yourself and Share with Your MS Clinician

* What is the symptom?  * Where is the symptom?  * When does the symptom occur? 

* How long have I had it?  * Have I ever had this symptom before?
* Has it come and gone, come and gone and come back, or come and stayed for 24 to 48 hours or more? 

* Has the symptom worsened since it started?  * Has it started in one area and spread to another area?
* How severe is the symptom?  * How does the symptom affect my ability to perform everyday activities? 

* Has the symptom improved on its own since it started?  * What have I done to try to relieve the symptom?  * Did it help?
* Do I have the flu or an infection?  * Have I become over-heated?

How are MS Relapses Treated?

The good news is that not all exacerbations require treatment. Mild sensory changes (numbness, pins-and-needle sensations) or bursts of fatigue that don’t significantly impact a person’s activities can generally be left to get better on their own.  If they don’t, or they expand into other symptoms, the relapse may need to be treated with a course of intravenous steroids.