By: Aaron Boster, MD
RELAPSE DEFINITIONS
Attack, relapse, flare up, exacerbations – they all means same thing. Both formal and informal definitions of MS attacks are reviewed. Formal: something like “an acute or subacute onset of neurologic symptoms, occurs in absence of a fever, lasts longer than 24 hours, occurs in absence of a fever. The person with MS may recover either completely or partially from this. If recovery is incomplete, then the person may accrue neurologic deficit and disability.” Sorry I know that’s dense. It’s worth considering each element but that’s outside the scope of this video.
An informal definition might be “something bad happens (new neurological symptoms) and it won’t go away after 24-48 hours!”
PSEUDO-RELAPSE
We also discuss the concept of a “pseudo-attack” or “pseudo-relapse”. This is the recurrence or worsening of old symptoms under certain circumstances such as overheating, overexertion, fevers, infections.
WORKING UP AN MS RELAPSE
For educational purposes, we then talk about important steps to take when working up a relapse. These include being seen and examined by you provider and ruling out infections (most commonly UTI).
HOW TO TREAT AN MS RELAPSE
We discuss the use of 1st line therapy for treating MS attacks: high dose IV or oral steroids and discuss the differences. We discuss 2nd line options for severe attacks that are refractory to 1st line steroids. This includes IVIg, ACTH, and total plasma exchange (plasmapheresis).
COMMENTS? QUESTIONS?
How was your last attack treated? What was your last pseudo-attack triggered by? I’d love to hear your comments and questions below!
NB: this video was for educational purposes only. Does not replace talking to your provider.
We intend to EDUCATE, ENERGIZE & EMPOWER those impacted by Multiple Sclerosis.
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