Can Tysabri Stop Recurrent Remission From Multiple Sclerosis

Trigger for MS flare-ups

Multiple Sclerosis Relapses - Causes & Countermeasures

Recurring attacks (also called exacerbation, relapse, attack, relapse or episode) are characteristic of the relapsing-remitting form of multiple sclerosis (RRMS). This form is diagnosed in approximately 85% of all patients with MS. Around 15% of those affected have what is known as primary progressive MS (PPMS). The disease develops continuously without any noticeable remissions.

Characteristics of an MS relapse

An MS flare-up can include one or more symptoms that last for 24 hours or more. It can last anywhere from a few days to several weeks or even months. If there is a flare-up, symptoms must be specific to MS and not caused by other causes such as infections. Two different attacks are separated by a recovery time (remission) of at least 30 days. No two flare-ups are alike, symptoms vary from person to person and from one flare to another.

How does an MS flare happen?

The underlying mechanism for a flare-up is the immune attack on the myelin sheath (the outer insulating layer) of the nerve fibers. This attack damages the myelin, which slows or disrupts the transmission of nerve impulses and causes the symptoms of MS. These include problems with the sense of balance, coordination, vision, the bladder, memory and concentration, mobility; also tiredness and weakness, numbness or pinprick-like pain. Symptoms vary from mild to severe. Remission occurs when inflammation subsides and the myelin sheath is replaced so that neuronal signal transmission is restored. However, remission does not necessarily mean that the symptoms will go away completely. Some people may feel the same as they did before the exacerbation, while others may experience new symptoms.

What causes MS relapses?

There are a number of factors that can trigger MS flare-ups, but they vary from person to person. Often one cannot find a cause. However, if you know your individual triggers, you may be able to deal with them better and reduce the likelihood of an exacerbation. The following triggers are common:

  • stress
    Stress can increase the incidence of MS exacerbations. You can never completely avoid stress, but you can reduce it or learn ways to deal with it better: Exercise, meditation, yoga, and behavioral therapy are all suitable.
  • lack of sleep
    Insufficient sleep can lead to an MS flare-up. Get regular and adequate (7 to 8 hours) sleep.
  • Medication
    Long-term exposure to your MS medication can increase the risk of a flare-up. Therefore, take your medication regularly as directed by your doctor.
  • Smoke
    Smoking is a risk factor for multiple sclerosis exacerbations. If you smoke, MS may flare-ups and disability progression more often. Quitting smoking and not smoking in your immediate surroundings can do much to improve your disease outcome. Your doctor or pharmacist can recommend smoking cessation products.

Treatment of exacerbations

The good news is that not all exacerbations require treatment. Slight sensory changes (numbness, pinpricks and the like) or signs of fatigue that do not significantly affect the activities of those affected can generally remain untreated.

Short-term administration of high-dose corticosteroids is recommended in the event of severe exacerbations (e.g. impaired vision, severe attacks of weakness or impaired balance) that impair mobility, safety or the overall quality of life of the patient. This inhibits the inflammation and leads to a faster resolution of the symptoms.

How can you reduce the risk of an MS flare-up?

We've already provided some pointers on how to reduce the risk of MS flare-ups in the triggers section. In addition, a healthy lifestyle with a balanced diet and regular exercise helps in general.

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