A flare-up of new symptoms or worsening of old symptoms. If you think you may be experiencing a relapse, refer to the Patient Relapse Decision Guide.
Relapses are unpredictable. They can occur suddenly or progress over days to weeks. If you are not sure, you can always call your health care provider to help you decide.
A relapse last at least 24 hours for new symptoms (48 hours for old symptoms). It is separated from a previous relapse by ≥30 days. They can last days to months.
Generally, they resolve without treatment. For severe relapses, treatment with steroids may be prescribed.
Common symptoms of a relapse.
Increase in fatigue
Vertigo / dizziness
Heavy legs (like wearing cement shoes)
Influenza, Hepatitis B, Varicella and tetanus vaccines do not increase the risk of having a relapse.
Relapses are less common during pregnancy, especially in the 3rd trimester
Relapse rates tend to increase during the three months after delivery, but most mothers do not have relapses
Breast-feeding does not appear to affect relapse rate
Painful or disabling relapses that interfere with daily activities can be treated with steroids:
Intravenous Methylprednisolone (Solu-medrol ®) and/or oral Prednisone are most commonly prescibed
Solu-medrol ® is given at a dose of 500-1000mg for 3-5 days
An additional oral tapering dose of Prednisone is sometimes given but this is less common
Common side effects
Water retention (increase blood pressure) Headaches
High blood glucose levels Palpitations
Upset stomach Insomnia
Increased appetite Metallic taste in mouth
Less Common Side Effects:
Mood swings Increased risk of infection
Allergic reactions Irregular menses
Acne Reversible memory impairment
Rare but possible steroid induced psychosis
Long-term side effects:
High blood pressure Osteoporosis
Hardening of arteries Blood sugar problems
Before using steroids, tell your doctor if you have:
High blood pressure
If pregnant, consult your doctor and steroids can be prescribed after 12 weeks of pregnancy if needed
Questions you should think about regarding relapses:
Call your neurologist or nurse if your symptoms bother you or if they last for more than 24 hours. Your neurologist or MS nurse can determine if you are experiencing a relapse and give you medication to ease the symptoms, or if you need to come in for an assessment.
Relapses can be treated with steroids, but your neurologist may prescribe other medications.
This can be discussed and assessed by your neurologist on a case by case basis depending on the severity and the number of relapses experienced during your MS treatment.