Pseudo Exacerbations and MS- The Real Deal

Patient Expert

So, are you crazy? Imagining things? Faking? Just looking for attention? You know what a multiple sclerosis exacerbation is, but what does it mean when your doctor tells you that you are having a 'pseudo' exacerbation?

Merriam-Webster's Online Dictionary defines the word 'pseudo' as:

Being apparently, rather than actually, as stated: sham, spurious

Don't let the word get you down. Your doctor is not accusing you of being a sham. In this case, pseudo has a very different meaning.

A pseudo exacerbation is a flare up of existing symptoms caused by another medical event, such as a urinary tract infection, flu, or elevated body temperature. Pseudo or not, it can stop you in your tracks as sure as any true exacerbation. However, new lesions are not being formed and your MS in not really progressing.

True MS exacerbations are caused by inflammation in the central nervous system which damages the myelin and disrupts the transmission of nerve signals, causing a wide variety of symptoms. This type of event can cause new symptoms and permanent damage, lasting from 24 hours to several months. Severe exacerbations may be treated with steroids in order to reduce inflammation and shorten the length of the exacerbation.

My multiple sclerosis diagnosis came in January of 2004. Since that time, I have experienced at least three attacks per year, lasting a month or more. MRIs have shown no new lesions in that same time period. Whether or not that is due to my medication of choice, Copaxone, is an unknown, but it indicates that no change in medication is required, and no further damage has taken place. That's the good news

The fact that we now understand that these are pseudo exacerbations helps a great deal emotionally, because I know that my MS is not progressing to the point of more lasting damage and disability. On the other hand, it doesn't change the fact that for long periods of time, I cannot walk, drive or work. These pseudo attacks have taken a toll on my overall health and well being. What it is called has little effect on my day-to-day reality. That's the bad news.

The answer lies in your general health. At the earliest signs of illness or infection, a call to the doctor is warranted. A very high percentage of people with MS have recurring urinary tract infections, a common cause of pseudo exacerbations, which may be treated.

If your neurologist has not yet brought this issue to your attention, please initiate a conversation about pseudo exacerbations during your next visit. Treatment of underlying conditions may just put an end to these attacks!

If you have been told that you are having pseudo exacerbations, please share your story with our community.