Is your MS flare-up real or is it a pseudo-relapse?

Have you had a multiple sclerosis relapse recently? Actually, would you know if you had? In fact, would you be aware whether you are had a relapse or a pseudo-relapse?

Pseudo? What’s that? Read on.

A true relapse – or flare-up, exacerbation, even attack – is a time of new or worsening of MS symptoms.

For your episode to be recognized as a true MS relapse, four conditions have to be met. These are:

•       pseudo-relapse Existing symptoms of MS must have become worse or new symptoms appeared.

•        Symptoms must last at least 24 hours.

•        Symptoms must occur at least 30 days after the last relapse.

•        There must be no other explanation for the symptoms.

However, even knowing this list, identifying what you have can be difficult. And it matters not whether you have had MS for years or are newly diagnosed. Telling the difference between a true or pseudo-relapse is more than a little tricky.

Telling the difference

On the upside, pseudo-relapse symptoms tend not to last long. Indeed, they may resolve within a day. Additionally, if your symptoms are caused by something else that can be treated, such treatment will resolve the problem.

Most importantly, pseudo-relapses are not caused by new damage to the central nervous system. A pseudo-relapse is NOT associated with an active MS lesion on MRI.

So, what are likely to cause pseudo-relapses? Well, they may be caused by heat sensitivity or infections including the common cold.

Once you get over these infections, your MS symptoms should get better.

Medications, both for MS and for other conditions, can also cause new symptoms. Be sure to discuss any medications you are taking with your healthcare provider.

True or pseudo-relapse?

Here are some clues to help you decide if your episode is true or not.

Timing: If your worsened symptoms resolve fairly quickly, it is likely that you may have a pseudo-relapse.

Old symptoms: Reappearance of old symptoms is more common in a pseudo-relapse. Generally, you will not experience another true relapse in exactly the same way as a previous one.

Types of symptoms: Some worsened symptoms are more likely to be a pseudo-relapse than a true relapse. These include sudden worsening of spasticity and pain, which are certainly seen in MS, but are rarely due to an acute relapse.

As someone with secondary progressive MS, and who has inactive lesions, I don’t get true relapses. Pseudo-relapses are, though, a way of life – especially if I have an infection.

I have been sneezing a lot in the past few days and am starting to get that ´blocked up´ feeling – sure signs that a cold is on the way.  Oh joy, my MS symptoms are set to get worse temporarily – my very own pseudo-relapse.

* * * * *

Affiliate disclaimer: This affiliate disclosure details the affiliate relationships of MS, Health & Disability at with other companies and products. Read more.

* * * * * is the personal website of Ian Franks, a freelance medical writer and editor for various health information sites. He enjoyed a successful career as a journalist, from reporter to editor in the print media. He gained a Journalist of the Year award in his native UK. Ian received a diagnosis of MS in 2002 and now lives in the south of Spain. He uses a wheelchair and advocates on mobility and accessibility issues.

* * * * *

Note: Health-related information available on 50shadesofsun website is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. I am not a doctor and cannot and do not give you medical advice. You should seek prompt medical care for any specific health issues and consult a doctor before starting a new diet or exercise programme. Any opinions expressed are purely my own unless otherwise stated.

Taking the rough with the smooth

In my wheelchair on a better day.

In my wheelchair on a better day.

As everyone affected by multiple sclerosis knows, whether living with it personally or because someone close to you has it, there will be good and bad times. Some may be limited to a day; others can be much longer.

Since forsaking the cloudy skies and rain of Britain for the sunnier and drier climes of the south of Spain, albeit that it is winter here too, I have noticed significant improvements.  I have been enjoying a prolonged good spell with a drastic reduction in both the number of falls and of the amount of time seriously affected by fatigue.

Two days ago, however, it was the start of a bad time. It started with, of all things, a stomach ache but that in no way warned me of what was to come.

After watching me fall asleep in my armchair in the middle of the afternoon and then seeing me fall on the way to the bathroom, my wife Lisa decided it was time for me to go to bed and there were no protests from me. The pain was still there and fatigue had set in. And I don’t mean tiredness; fatigue is so much more than being tired.

I did try and get up later but only as far as my electric wheelchair and, even then, I soon returned to bed.

Yesterday morning, I awoke to discover my stomach ache had gone but, instead, it felt as though there was a tight band around my body – widely known as the ‘MS hug’. I spent awhile on my computer until, trying to get around indoors led to two more falls, resulting in Lisa insisting that I return to bed. Once there, I was soon oblivious to the world.

Today, Thursday, I have only got out of bed to visit the bathroom which, so far, I have managed without falling. My legs seem to be becoming mine again. I am sitting up in bed while writing this. I think that the worst of the fatigue is behind me.

Maybe, just maybe, I’ll try and get out of bed again this afternoon. If I can make it from bed to armchair – on my feet without falling, that would be a major improvement. Not much to ask, is it? Just ask the uninvited guest in my life; ask my ‘friend’, multiple sclerosis.