People with relapsing remitting MS often experience relapses,
during which they may experience new MS symptoms or the
worsening of existing ones, followed by a complete or partial
recovery (also called remission). These episodes are often caused
by inflammation in the brain or spinal cord, but they can also
happen for other reasons, such as exposure to heat and humidity,
overexertion or fever.
To be a true exacerbation, the episodemust occur in the absence of any other cause, last at least 24 hours and be separated from the
previous one by at least 30 days. MS relapses range from a few days to a few months in
duration. Symptoms can be very mild, or severe enough to interfere with a person’s ability to
function.
Not all relapses require treatment. Mild sensory changes (numbness or tingling) or episodes of
fatigue may resolve on their own. Severe symptoms, such as vision loss or marked weakness,
that interfere with a person’s mobility or safety are often treated with a short course of highdose steroids. These medications do not provide long-term benefits or change the course of
MS, however, there’s evidence that they can help speed the recovery from a flare. Steroids are
generally most effective if started soon after the beginning of a flare (within 14 days). Even with treatment, improvement is often gradual and some symptoms may take months to
completely resolve.
The type of steroids used to treat MS relapses are called glucocorticoids. They belong to alarger class of steroids called corticosteroids. These medications are designed to mimic cortisol,
a hormone produced by the adrenal glands, which has anti-inflammatory effects. Several different corticosteroids are used to treat MS relapses. Some can be
taken orally, while others are administered via an injection or
intravenous (IV) infusion at a clinic or hospital. These drugs have
been used to treat MS since the 1940’s. They are also used to treat
other health conditions in which inflammation plays a role, such
as asthma and severe allergy attacks.
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