Multiple Sclerosis Health Center
When MS Attacks
Taking Care of Yourself During an MS Flare-Up
Call it a flare-up, call it an exacerbation, call it a relapse -- whatever you call it, you can't call it fun. Many people with relapsing-remitting multiple sclerosis can go days, weeks, months, or years without major changes in their symptoms, but then suddenly, an MS relapse hits.
How do doctors define an MS flare-up? There are a few key factors:
Ampyra for Multiple Sclerosis Treatment
Multiple sclerosis (MS) is a chronic and often disabling disease of the central nervous system, which consists of the brain, spinal cord, and optic nerves. The disease damages myelin, a fatty substance that normally surrounds and protects the nerves. It can also damage the nerves (called axons) within the central nervous system. Results of this damage can range from mild (numbness in the limbs) to severe (paralysis or vision loss). About half of people with MS experience problems with concentration,...
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- The development of a completely new symptom of MS. You’ve never had vision problems before, and suddenly you can’t see out of your left eye.
- Worsening of an existing symptom or one that you’ve experienced in previous relapses. Maybe you’ve had some numbness in your left leg before, but now you can’t feel anything above the knee.
- It must last at least 24 hours. That’s because a flare-up is a signal from the brain that a new lesion is being formed. "You can’t lose myelin and regrow it faster than 24 hours," says Edward Fox, MD, PhD, clinical associate professor of neurology at the University of Texas Medical Branch and director of the MS Clinic of Central Texas. "If a symptom lasts less than 24 hours, it’s something transient that’s not related to a new lesion.
- It will reach a plateau after awhile, and stop getting worse.
- You may recover completely, with the symptom going away entirely, or there may be some permanent loss of function or sensation.
"Most exacerbations evolve over a period of days, sometimes over weeks. They can go on for as long as a year," says Bruce Cohen, MD, director of the MS Clinic at Northwestern University Feinberg School of Medicine. "Then they usually do improve, sometimes completely and sometimes not, but recovery can be quite slow."
How to Tell When an MS Relapse Isn’t a Relapse
Sometimes you may fear you’re having a relapse, but it’s really something else. For example:
- The flu. If you have a fever or an infection, you may experience MS symptoms that feel like a flare-up, but it doesn’t mean that a new lesion has developed. "Rather, it’s a temporary disruption in areas of old damage where nerve impulses were conducting normally," says Patricia Coyle, MD, professor of neurology at the State University of New York at Stony Brook and director of the Stony Brook Comprehensive MS Center. So once you recover from the fever or infection, things should go back to normal relatively quickly.
- Fatigue. Sometimes if you’re overworked, stressed, and not getting enough sleep, MS symptoms may trouble you more than usual. Getting rest and taking some time for yourself can put you back on track. (But if the fatigue continues, especially if it’s extreme, that may be a signal of an exacerbation.)
- Short-term symptoms. If you wake up in the morning and your right arm is numb, but the numbness goes away after you shake it out, that’s not an exacerbation. Even if it happens every morning -- as long as the numbness goes away quickly, it’s probably related to your sleep position and not MS.
