Know the signs of an MS relapse and how to handle it.
When a patient is diagnosed with relapsing-remitting MS, their antennae are automatically up for signs and symptoms of a relapse, which is a short-term flare that involves new symptoms in a specific spot on the body. The symptom usually comes on over the course of days to weeks and then goes away over days to weeks.
There are a lot of misconceptions around MS relapses and how to handle them. Here, neurologist Michelle Fabian, MD, clears things up.
What Are Symptoms of an MS Relapse?
“There are some very typical relapse symptoms of MS,” says Dr. Fabian. Those include optic neuritis (a temporary visual blurring), dizziness, numbness, or weakness. “It’s a localized thing. Either it would be one half of the body or maybe both legs, but something that’s localized on the body.”
What Causes an MS Relapse?
The truth is, doctors don’t know. “We don’t really understand why a patient has the onset of a relapse but for some reason the immune system turns on and the white blood cells go into the central nervous system and create a new lesion in the brain or the spinal cord,” explains Dr. Fabian. She says there are two things known to make relapses more likely:
1. Infection, like a flu: “If a person has an infection with relapsing remitting MS, most of the time they don’t develop a relapse, but sometimes they can,” says Dr. Fabian. What happens is the the immune system gets activated to fight the infection and then continues to attack the central nervous system.
2. Being postpartum: For some women after they have a child, they have an increased risk of having an MS relapse.
How Are MS Relapses Treated?
This might be surprising, but not all MS relapses require treatment. The regular immune-modifying medication patients take helps prevent relapses from happening in the first place. But should a relapse occur, treatment may only be necessary if symptoms are taking a toll on your safety or quality of life.
“We have them come in, we examine them and we monitor the symptoms. The reason we treat a relapse is if a person has trouble functioning. That would typically mean seeing, walking or using their hands or they’re in pain, which is rare and then we would use steroids,” says Dr. Fabian. These drugs don’t prevent relapses from happening, but they can help decrease the time the patient has a relapse.
What Should a Patient Do During a Relapse?
First things first, always call your doctor. “I like to worry about it with you,” says Dr. Fabian. “I don’t want you to just be at home worrying about that symptom by yourself.” Second, it’s important to know that, with newer MS medication options, relapses actually happen much less frequently; it can be years between them. So a relapse could be a sign that your current MS treatment isn’t working as well as it should be. And your doctor might want to consider changing your treatment plan.
Second, take things easier. Try to avoid activities that will make you feel worse. You might need to take public transportation or drive to work instead of walking, for example. And carve out time for plenty of rest, so you “give your body a break until you can get better,” says Dr. Fabian.
Patient education: Multiple sclerosis in adults (The Basics). UptoDate, 2017. (Accessed on December 22, 2017 at https://www.uptodate.com/contents/multiple-sclerosis-in-adults-the-basics)
Managing Relapses. New York, NY: National MS Society. (Accessed on December 22, 2017 at https://www.nationalmssociety.org/Treating-MS/Managing-Relapses)