What is an exacerbation?

An exacerbation of Multiple Sclerosis can also be referred to as an attack, a relapse or an episode. All the terms all mean the same thing which is the occurrence of new symptoms or worsening of an old symptom. These range from mild to severe enough to interfere with a person’s ability to function in daily life. The exacerbation will follow the following criteria:

• Previous symptoms become more severe or new symptoms have started to show.
• Symptoms last longer than 24 hours, commonly lasting days or weeks.
• A total of 30 days has passed since the start of the previous relapse.
• Healthcare provider has ruled out all other possible causes for an exacerbation, including infection, heat, and stress.

It is critical to know when this is happening because early treatment can help reduce the impact on the person’s body. It must be known that no two exacerbations are alike and can change slightly.

The reason an exacerbation occurs is due to the immune system attack on the myelin sheath, which then causes slow or interrupted neuronal signals in the brain and spinal cord. An exacerbation can consist of balance problems, coordination, eyesight, bladder function, memory or concentration problems, mobility, fatigue, weakness, numbness or needle-link sensation.

Mild symptoms such as fatigue, numbness, and needle-link sensation could potentially improve on their own and not require treatment. More intense issues could be considered a severe exacerbation which could include vision loss, extreme weakness, and poor balance. During a severe exacerbation, a person’s daily activities could be affected and a short course of high-dose corticosteroids may be recommended by the specialist.

The high-dose of steroids helps reduce the severity and duration of the exacerbation. Even though steroids work well with the exacerbation, they can also have some rather unpleasant side effects including increased appetite, weight gain, fluid retention, high blood pressure, irritability, confusion or delirium, increased risk for infection, and easy bruising.

Symptoms for each person with Multiple Sclerosis are different. Being aware of common triggers for an exacerbation is vital for each person to know and even though symptoms can occur without any notice it is important to try avoiding certain things the best one possibly can.

4 Common Triggers for an Exacerbation:

• Stress- Part of living with an illness like MS is emotional stress which can lead to other common MS symptoms such as depression. Stress does have the potential to lead to additional MS symptoms such as fatigue and confusion. It is a crucial part of MS treatment to have a good and solid support network of people that can help out both physically and emotionally.
• Fatigue- Sleep is essential for those with Multiple Sclerosis. Small issues like lack of sleep can trigger MS symptoms. It is very important to have good healthy eating habits, sleep well, and getting exercise daily which will help combat MS fatigue.
• Infection- Infections cause about one-third of all exacerbation. Urinary tract infections are very common because some people with MS have reduced bladder function. Any infection can weaken the immune system; even the simple ones like a cold or the flu and cause an exacerbation. It is extremely important to avoid being around sick people, but when it is unavoidable be sure to wash hands frequently.
• Heat- Infections leading to fever can be something to worry about considering increased body temperature is a very common trigger. MS symptoms, especially tingling gets worse in the summer because of the heat. It is predominant to get into the air conditioning or take a cool shower to reduce heat symptoms from occurring.

Thank y’all for visiting my site and reading about what an exacerbation is. Speaking from personal experience an exacerbation can be awful and also frustrating. Even though I do know that steroids help the episode duration be shorter, they cause my mood to change so much that I have a hard time with them. They cause my temper to come out much faster than it normally would and also cause me to feel edgy and unable to sleep.

For any of you that have experienced an exacerbation and were put on steroids, how did the steroids make you feel and did they help the episode not last too long? Also, if you have anything you would like to add to this, please let me know. I always want to spread the awareness as much as I can because I think it is important. Even in 2020 I do still think there are a lot of misconceptions about MS and people are very quick to judge, which can cause feelings to be hurt. Please never forget that I am always sending y’all LOTS of love , comfort, and many positive vibes!

Always, Alyssa