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Relapse vs. PseudoRelapse

I am a 39 yo who was dx with MS in 2013 about a year and a half following pregnancy.  First episode met McDonald criteria for MS dx and it runs in the family.  I have not had a relapse since; however, I recently had 3 weeks of left foot and ankle numbness (intermittent and mild).  I had just gotten over an upper respiratory virus and was suffering from exhaustion/fatigue and stress. A new MRI of brain/spine showed no enhancement (so no active lesions) and identified one new, smaller lesion in my c-spine that was not picked up in the original MRI.  As I’m reading, that’s not a big deal in that the first MRI was done with a 1.5T machine whereas my new MRI was done with a 3T machine.  I had a clean MRI in May of this year as well.  My NP doesn’t know what to make of this but a neurologist friend seems to think this could just be transient demyelination.  Has anyone experienced something like this?  Thanks.  Oh, and I’m not on disease-modifying therapy but obviously this little scare is having me think twice about getting on some.  Thanks.
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987762 tn?1331027953
COMMUNITY LEADER
Hi and welcome to our little MS community,

A couple of things to keep in mind, the human body is a more accurate predictor of you having an attack (relapse) than the MRI. A relapse is the return of prior symptoms (sx) and or the worsening of sx and or experiencing new sx's for a minimum of 24-48 hours. If this was a return or something new to you and it lasted 3 weeks before remitting, it was more likely a relapse regardless of if the MRI showed it or not.....  

A raise in temperature can cause a temporary worsening of sx's, which is called a pseudo relapse, it's not a genuine relapse because you go back to your normal again once you've cooled down and rested. Unfortunately  infections (eg flu, uti etc) can cause both a pseudo and actually set off a relapse, and if it started after getting over the upper respiratory virus, it's quite possible the virus set off your immune response to go nuts and resulted in a relapse.  

MRI's are noted to not always show all the activity that's going on, the 3T show about 25% more lesions than the 1.5T and they only have a window of approx 30 days to catch the lesions enhancing, so it's possible the MRI isn't showing up all the damage your MS is doing. It's actually one of the main reasons why MS is still classed as a clinical diagnosis and the MRI is still not as significant as a persons clinical signs of attack.

Disease Modifying Drugs (DMD's) are highly recommended, they don't always work out and it's not uncommon to try a few before finding the one that suits you best but the main point is........DMD's are the only thing known to slow down the disease its self, and the research proves DMD's provide lower disability levels in the long term......

Cheers........JJ    

Helpful - 0
1831849 tn?1383228392
Hi MNM -

I don't think I've ever heard of transient demyelination, so I'm not sure what he meant. As JJ said, any symptom that is either new or old but worse, and lasts more than 24 hours is generally thought to be signs of a relapse.

The proper labeling is important if you want to consider IVSM to deal with the relapse. This is different than DMD's. IVSM treats the inflammation not what caused the inflammation.

I do agree with JJ about DMD's. For me it's important to everything possible to keep my MS at any...

Kyle
Helpful - 0
667078 tn?1316000935
There are two things in MS nerve damage and inflammation. When you have inflammation you have symptoms. When the inflammation goes away so do symptoms. Inflammation can last weeks or months. If symptoms do not go away that is nerve damage. Nerve damage can happen with or with out symptoms. Disease modifying drugs slow progression. They do not fix nerve damage. So if you wait until you have nerve damage to go on a DMD you may not go back to where you were originally.

It is everyone's choice whether to go on a DMD. You can still have nerve damage with a DMD but is is usaully less. They have worked at slowing progression. If you meet a MSer who was diagnosed before the MS drugs they will tell you they wished they had had DMDs. Since DMDs came out there are a lot less MS patients in wheel chairs.

The DMDs may seem scary. It is like a diabetic needing insulin or a cancer patient needing chemotherapy. No one likes to be on any of these drugs but they do help.


I honor anyone's right to treat there illness there way as long as they understand the risks. Everything boils to benefit and risk.

Alex
Helpful - 0
Avatar universal
Thanks everyone.  I really appreciate your comments and insights.  Have any of you used dietary changes/supplements/acupuncture, etc. to help treat your MS and have you had success with it?
Helpful - 0
667078 tn?1316000935
These all help with your over all health not so much for treating MS. They are complimentary treatments for MS.

Alex
Helpful - 0
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