According to the National MS Society, an exacerbation (or relapse, flare-up or attack) "causes new symptoms or the worsening of old symptoms." Sometimes symptoms are severe; other times they are mild. Sometimes an exacerbation flares up only one symptom; other times there will be multiple times.
Symptoms differ between people and can even be different relapse-to-relapse. It may be difficult at times to identify the relapse, but there are certainly things to look out for. Some of the most common relapse symptoms include:
- Trigeminal neuralgia (sharp shooting paints in the face)
- Option neuritis (losing sight in one eye)
- Numbness or tingling in the legs or feet Dramatic increase in fatigue
- Muscle spasms
- Difficulty swallowing
- Difficulty with speech
- Cognitive difficulties
- Bowel or bladder difficulties
- Problems with balance and gait
But what is causing these symptoms to flare? Some sources say that relapses are known to immediately follow a virus or infection. In some cases, patients are recommended to avoid the heat if relapses occur with frequency. Patients should be wary of severity and duration of flares, as symptoms not lasting more than 24 hours may not be a relapse at all, but could instead be a pseudoexacerbation.
The National Institutes of Health have conducted studies which identify stress as a cause for a flare. They found that "acute events, but not chronic difficulties, predicted relapse occurrence." They note some factors that could contribute to a patient suffering from a relapse, including stress. Certainly nobody tries to be stressed, so what do I do?
Multiple sclerosis is characterized by the demyelination of the nerves in the brain, creating lesions. The flare itself is caused by inflammation in the nervous system, which causes demyelination. As inflammation decreases, the relapse begins to subside. Hence, steroid treatments are used to reduce inflammation quickly and effectively. The location of these lesions indicates which symptoms you may experience. These drugs are often administered in the neurologist's office or in a hospital.
The next step in the process toward fully controlling a relapse is to address the relapse as quickly and effectively as possible. The National Hospital for Neurology and Neurosurgery is proposing that, in the future, patients be able to take intravenous steroids in a home setting. This could eliminate the trip to the neurologist and could help expedite the process to control a relapse.
In addition to steroids, the National MS Association recommends the use of plasmapheresis for those who may not be responding to steroid treatments, though the long-term effectiveness has not been proven.
Published On: November 03, 2011