What is a Multiple Sclerosis Relapse?

23,851
5
Published 2018-03-11
What is an MS relapse? This video takes a deep look into answering the question "What is an MS relapse?"

RELAPSE DEFINITIONS
Attack, relapse, flare up, exacerbations - they all means same thing. Both formal and informal definitions of MS attacks are reviewed. Formal: something like "an acute or subacute onset of neurologic symptoms, occurs in absence of a fever, lasts longer than 24 hours, occurs in absence of a fever. The person with MS may recover either completely or partially from this. If recovery is incomplete, then the person may accrue neurologic deficit and disability." Sorry I know that's dense. It's worth considering each element but that's outside the scope of this video.

An informal definition might be "something bad happens (new neurological symptoms) and it won't go away after 24-48 hours!"

PSEUDO-RELAPSE
We also discuss the concept of a "pseudo-attack" or "pseudo-relapse". This is the recurrence or worsening of old symptoms under certain circumstances such as overheating, overexertion, fevers, infections.

WORKING UP AN MS RELAPSE
For educational purposes, we then talk about important steps to take when working up a relapse. These include being seen and examined by you provider and ruling out infections (most commonly UTI).

HOW TO TREAT AN MS RELAPSE
We discuss the use of 1st line therapy for treating MS attacks: high dose IV or oral steroids and discuss the differences. We discuss 2nd line options for severe attacks that are refractory to 1st line steroids. This includes IVIg, ACTH, and total plasma exchange (plasmapheresis).

COMMENTS? QUESTIONS?
How was your last attack treated? What was your last pseudo-attack triggered by? I'd love to hear your comments and questions below!

****************************************
Twitter: twitter.com/AaronBosterMD

Facebook: www.facebook.com/AaronBosterMD

SUBSCRIBE YouTube: youtube.com/c/AaronBosterMD
********************************

SHARE this video:    • What is a Multiple Sclerosis Relapse?  

SHARE video answering views questions about attacks:    • Multiple Sclerosis Vlog: Answering Vi...  

********************************
These videos do not provide medical advice and are for informational/educational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any of our videos.

All Comments (21)
  • @lisaleem9593
    I had IV steroids. Messed my veins up. But cleared my optic neuritis.
  • @Mshellokittyzzz
    as someone living with Ms and dealing with many doctors that dont have the time to break things down for me, it's great watching your videos. you are a great teacher and break things down understandably.
  • @lisaleem9593
    I am a nurse. When I first experienced what seemed to be MS. Such as cognitive fog that effected my job and not walking straight, eye pain, double vision. I told my PCP I think I have ms. He told me no. He did a Neuro test in his office and brushed me off. That was in 2012 .. i lapsed in 2015 I was newly diagnosed with MS. I told my PCP and I fired him.
  • @sylviaistheone1
    I had a iv steroids I was diagnosed in November in 2019 now I’m going through therapy your videos been very helpful I appreciate it many blessings to you sir
  • @doctorken2k
    I had them all except acthar. You are bringing up troubling times. But this helps. It brings understanding to my story.
  • @janehouska224
    Dr. B, Greatly appreciate this video. I had an attack in 2018. My neuro at the time did not believe it was not an attack (64 yo at the time), said I was too old. I was deflated. She sent me for an MRI of spine that came back unremarkable. Saw my PCP shortly after that who sent me for a brain MRI. Was lit up like a Christmas tree! My neuro treated with solumedrol for 3 days, no follow up. Fast forward 3 years, I finally changed neuros. He was my former neuro who had left where I was getting care. He pt me on solumedrol for 5 days followed by a 12 day taper of oral prednisone, then a follow-up. Sorry I did not go to him earlier …., an insurance thing. I am not back to where I was prior to attack in 2018, unfortunately. Thinking I will take some of the things you discuss in this video and discuss with him. In the meantime, he asked me to consider participating in a clinical trial trial, ATA—188 that involves infusions with T cells that kill B cells with EBV. Are you familiar with this study? I am currently on Ocrevus. It concerns me that this trial is at phase 2. I would be all over it if it were phase 3. Sorry this was so long!
  • @loriemorris4629
    Thank you, for explaining, this to me, I have MS , and no one, explained, it to me!. I've been having trouble with my left hand!
  • @josephinej2826
    hello, Dr. Boster, I really appreciate the way that you have defined what a plasmapheresis is since I had to have that done 2 years ago after having 3 attacks within 3 months since corticosteroids weren't working after the second attack (I have had MS since I entered high school
  • @popcorn682
    The last attack that I had was 2-months after I was diagnosed. This attack was not treated, but I was referred to my amazing specialist right away and removed from the DMT that I was taking at the time. I am very grateful to have the medical team that I do. Thank you for educating so many people!
  • @MrJdifranco
    Thanks from Canada Aaron, very informative. Love the hoody btw👍🏻
  • Hi Dr Boster, I hope I can still reply to your questions, three years after posting this video ☺️ Since my diagnosis 2,5 years ago I have had 2 IV steroid treatments for different symptoms. Neither helped, but I didn’t get a follow up treatment like you mentioned. They sent me to a psychologist instead, because they didn’t see significant changes in the scans. I feel like I’m losing precious time 😔 I love watching your videos and learning to understand MS!! Keep up the good work 💪🌷
  • Hi Doctor Boster Your knowledge of medicine, and diagnostic in this vast arena are impressive. Your ability, willingness, and enthusiasm to help people in such a way, a huge way like this program on the media site YouTube, and what not is really, and I would say speaking for myself Extraordinarily helpful. I'm like so many, I'm under diagnosed. I'm also in a situation where I had lost my Treating Primary Care Doctor do too Abandonment without any advanced notification ATALL. And while under a multitude of Pharmaceutical interventions for Horrific high impact cranial nerves, Pain. Pain so absolutely mind to mouth screaming in agonizing hell. And I've always been considered by some as a first line tough guy whom'l risk life and limb to save a stranger, and so I guess it was. Thirty five years as a Tile Contractor and carpenter, and everything else from A to Z Science theology to high energy weaponry to nature's natural design and more. Sixth grade education, and competent to tackle advanced courses in electronic engineering testing and all for not the benefits of attendance, campus, or even a single conversation with physically with an instructor.? Read, Test, and pass. Born with severe prosop amnesia. Undiagnosed for thirty years I must have been referred to as bashful more times than there is sand along the shoreline of the seven oceans. Bashful, no just trying to figure out who Ya are folks so my staring was mostly just for my ears, nose, Mind, and memory were just not that good looking kinfolk and company ha ha ha OH Man. Obviously I am digressing to a new world's record.... I think my condition is HHSVS virus in nature, probably HHS-1. And because of the dispensations through time, year's with this "remitting and relapsing MS like creature I'm afraid my cognizant, my central nervous system is quite fried as testing back in 2013 confirm a substantial amount of ? injuries, and a substantial or just a to say I am not a star student of my own classroom anymore and I can't believe I just said that. A year and a half to two years now without any Professional Medical help. No Hospital, and no specialist, and no nothing He split town in the middle of the night, a few weeks after the hospital and ninety percent of my hometown went up in flames from the Camp FIRE. I was living thirty five miles away in a cheaper county and could only watch from a screaming position on a sofa where only the slightest touch to my scalp would signal foul agony. My pain is only modified by the degree that it is affected with what's on hand, my hand, and occasionally an n said OTC, or perhaps a chock my head off pot cigarette I am leaning towards the wax or butter oil whatever ha ha ha um yeah. I'd organize and fund a massive Pharmaceutical theft if I actually had a few hundred thousand dollars to throw at it in a micro second and have it hauled away to a subterranean local in ten ton trucks. But I can not now nor have I been ever able to fund that humorous climatic, not on a fixed income. Doctor Boster what percentage if any percentage actually exists in regards to MS and HHSVS virus origination to said description of symptoms mimicking the sky's the limit, except for Biblically Literate theological schoolers of my own classroom of one. Terms of discrimination like poly ganglionitis Episodica HS-1, or something like that you know more of than I obviously but literally there are countless many of research on this or that it's more than any household shovel can handle referring to my on practice of inadequate to handle me myself, and I.... Indeed, not even close. Untreated high impact Chronic Pain and stupid me, pain sucks. Ouch. 🚴💦.. 🍃... 🍃.... 🍃 Thanks for Sharing your Thoughts and Questions. Sincerely yours, Mr Bradley Bill Parker ✝️⛹️💁🤸🏀🤾 THAT'S 2 A N D T H A N K Y O U And always remembering to Thank our Heavenly Father, that's YHVH IN THE HEBREW Tongue. Why,? Because HE Deserves it. I personally could never Thank Him enough for all that He's done for me in my life time, In Christ's Jesus Precious Name Amen and That's THAT FOLKS 🚴💦🍃👩‍👦‍👦🌮
  • @ireneakoto8201
    Hi dr. I was diagnosed last year but I think I had been suffering from the symptoms for years. Anyway. Thanks so much for your videos. Very very little is known about Ms in my country so your videos are my source of info. Even my dr who is like the best sometimes seem not to know much about ms. And if I give her any info I gained from your videos she seems to think it’s wrong. But I always tell her ‘ am the one who has ms and I always relate anc gain from your videos. Thanks so much. Keep doing more.
  • @erniejoel1234
    Last time was IV solumedrol for 5 days. This is awesome Dr. Thanks for all the information.👍🏼👍🏼
  • My last MS relapse we decided on round 3 of Lemtrada! It's been really good.
  • @mattz5275
    Very informative video Dr Boster. I see allot of this in my FB groups. It's great to know all information about what's going on with yourself or someone. To answer your question I always use to use IV steroids when i had a flare. For me I acted like the Incredible HULK. Angry hungry and makes me very agitated. So I ask everyone around me to just bare with me. 🤦‍♂️