MS: Real Relapses vs. Pseudo-Relapses

Know the difference between real relapses vs. pseudo-relapses

MS: Real Relapses vs. Pseudo-Relapses

By Amy Abbott Published at February 5, 2014 Views 22,038 Comments 2

Most individuals with multiple sclerosis are intimately in tune with symptoms of the progressive disease, and always on guard for a relapse.

Yet, understanding if you are having a relapse or what physicians call a "pseudo-exacerbation" can be challenging, and even confusing.

According to an "Inside MS" article, the hundred-dollar term pseudo-exacerbation describes very real symptoms, including muscle weakness, tingling and spasms as well as blurred or dimmed vision for those with optic-nerve damage. According to author Diane O'Connell, "The difference between a true exacerbation is an actual worsening of the disease and lasts from several days to several weeks — or longer."

The article explained that the pseudo-exacerbation is a short-term relapse, generally over within 24 hours, that isn't related to inflammation within the central nervous system.

Confused? How can you tell if your symptoms are a full relapse or for a short duration? In one sense, it doesn't really matter as the symptoms present the same, and are as real as the disease itself.

O'Connell cited an example from Dr. Peter Dunne, Director, University of South Florida MS Clinic. Six of Dr. Dunne's patients visited the beach (Tampa is located near many Florida Gulf Coast beaches) at different times and stretched out in the sun. "Some of them had to be carried to their cars, by their friends, others called EMS, and all were scared like hell," said Dr. Dunne. "But a funny thing happened, after they had a chance to cool down, their symptoms passed — in every single case."

Lisa Emrich, who is the author of "Brass and Ivory: Life with MS and RA" and founder of the Carnival of MS Bloggers, offers her thoughts about the difference between a true relapse and one that is a pseudo-exacerbation. She notes that a relapse is the sudden onset of new or worsened symptoms more than 24 hours long. Of significance is that this relapse is separated from a previous one by at least 30 days.

The example of too much sun by Dr. Dunne is one that Emrich also mentions. She notes that a rise in body temperature doesn't jive too well with the central nervous system. Being outside in overly humid weather, overheating from exercise or sitting too long in a hot tub, whirlpool or sauna may bring on the same results.

Emrich said that stress, infection especially from a urinary tract infection, premenstrual syndrome and certain medications can trigger a reappearance of old symptoms or bring on new ones that mimic a full relapse.

Whether a pseudo-exacerbation or a full-blown relapse, the very real symptoms should be treated.

To learn more on this topic:
How Is an MS Relapse Defined?
MS Relapses: When to Call the Doctor
Understanding What Happens in a MS Relapse

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