By Julie Stachowiak, Ph.D., About.com Guide
About.com Health’s Disease and Condition content is reviewed by the Medical Review Board
MS relapses are one of the most frustrating areas of multiple sclerosis for patients, their doctors and loved ones to deal with and understand. The first year after my MS diagnosis, I was constantly wondering if the disappearing-reappearing-disappearing tingling in my feet was an exacerbation, because some days it would seem to be almost gone, then other days it would almost keep me from walking normally. Then I would have the girdle-band pain that was there for a couple of hours, then gone for three days, only to come back temporarily.
What a Relapse Is:
A relapse is a clinically significant event (meaning that it has outward signs and/or symptoms) caused by an MS lesion on your brain or spinal cord. It is either a worsening of symptoms that you already have, or the appearance of new symptoms. Relapses are also referred to as “exacerbations,” “attacks” or “flares.”
Causes of Relapse:
Relapses are caused by the inflammation that occurs when your immune system attacks the myelin surrounding nerves in your brain or spinal cord. Myelin is the protective coating that covers nerves and helps them conduct signals. When the myelin is attacked by immune cells, a “lesion” or an area of inflammation and eventual damage (demyelination) occurs, making the nerves less efficient in conducting signals. Your symptoms depend on the location of this lesion. For instance, inflammation in the cerebellum can cause loss of balance and coordination, while inflammation of the optic nerves can cause decreased vision.
Signs of a Relapse:
Some relapses are very obvious, for instance, losing your sight in one eye due to an attack ofoptic neuritis. However, other relapses may not be as sudden or dramatic and you may just feel extra “wobbly” or tired. The way to really know if you are having a relapse is to have an MRI with gadolinium (contrast material that is injected during the MRI scan). Gadolinium is drawn to areas of inflammation and “lights up” when a lesion is “active.” In this case, demylenation is currently occurring, and you are having a true relapse, rather than feeling symptoms caused by older lesions.
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