With multiple sclerosis, relapses are probably the most frustration-filled area of the disease. Apart from the person with complaint having to endure such annoying and painful relapses, that person’s family and physicians are also given a hard time.
Exacerbations
Earlier on, many assumed that the returning tingling in the feet, otherwise termed as paresthesia, is an exacerbation. There are some days where this paresthesia is nearly completely gone, and in some days it just prevents the person from ambulating. Aside from this disturbance in the lower extremities, there is also the girdle-band pain that just would not go away.
With these kinds of symptoms, it is best to see a neurologist right away, especially if the symptoms are starting to interfere with normal functioning.
What is a relapse?
Relapse is the term given to an occurrence wherein the signs or symptoms are clinically significant. Such event is usually caused by lesions associated with multiple sclerosis, specifically the ones located inside the brain and spinal cord. Relapses have also been given other terms such as flares, exacerbations and attacks.
What causes a relapse?
The inflammation triggered by an immune response within the body causes the relapses. Since multiple sclerosis is an autoimmune disorder, the immune system attacks its own cells including the healthy ones. In the case of MS, the myelin sheath is attacked.
The myelin sheath serves as the protective covering of the nerves. Aside from protection, it also aids in the proper conduction of signals and messages for appropriate communication between the brain and the rest of the body.
With a damaged myelin, a lesion forms and demyelization occurs. This makes the nerves even less effective in transmitting signals properly. The symptoms associated with MS greatly depend on where the lesion is located. For example, if the lesion is located inside the cerebellum, then it will primarily cause incoordination and general imbalance. On the other hand, if the lesion has damaged the optic nerve, then the resulting symptom is a decrease in vision.
What signals a relapse?
Some relapses can be immediately observed. For example, once optic neuritis attacks, vision is lost in one eye. In other relapses, however, there are more dramatic effects such as feeling fatigued and “wobbly”.
To be definite in saying that it was a relapse, there has to be an MRI scan with a gadolinium. This is just a contrast medium used for MRI scans. It is much more observable with viewing inflammation because it tends to be luminescent whenever a certain lesion is considered active. If the lesions are active, then it means that demyelization is still taking place. When this occurs, then it is, indeed, a true relapse, and not merely symptoms of past lesions.
True relapse
For a relapse to be considered true relapse, it has to occur for at least twenty-four hours. Mini-relapses can also take place, which are mainly comprised of quirky symptoms that do not usually last for more than a couple of minutes up to a few hours only. But mini-relapses are not true relapses.
True relapses take several weeks before they stop.
Sunday, January 3, 2010
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