MS Relapse

A multiple sclerosis (MS) relapse occurs when you have new or worsening symptoms lasting more than 24 hours. MS experts at Virginia Mason Franciscan Health deliver timely care that relieves symptoms and support that provides peace of mind.

Virginia Mason Franciscan Health delivers nationally recognized MS care, including attentive services for relapses. Our team developed an MS relapse action plan with easy-to-use guidelines for assessing new or worsening symptoms. This plan has been adopted nationwide as a best practice in MS relapse self-evaluation.

Relapses (also known as attacks, flare-ups or exacerbations) occur when immune cells attack your nerves’ protective covering (myelin). These attacks affect nerve function, causing symptoms that come on suddenly and are different or more intense than you’re used to. MS flare-up symptoms may go away on their own. If they become too bothersome, you may get relief from a high dose of steroids.

A sudden or severe onset of numbness is a common sign of an exacerbation. There may also be new or worsening: 

• Bladder or bowel problems
• Blurry or double vision
• Cognitive challenges affecting memory, concentration, thinking or your ability to communicate
• Dizziness or feeling unstable on your feet
• Muscle weakness in one of your limbs
• Slurred speech
• Unusual tiredness (fatigue)

An MS relapse action plan helps you assess relapse symptoms and know precisely what to do. The colors of the plan correspond with the level of concern and urgency you should have when deciding whether to contact us for potential treatment. 

The choice of whether to seek MS flare treatment is yours. However, we’d like to know when you think you’re having a relapse. You can call us or leave a message in your patient portal.

If you answer yes to any of the below questions, it is likely not a true inflammatory relapse. Instead, it’s more likely a pseudo-relapse or flare-up of old symptoms. 

• Do you have a cold, flu, or infection (bladder, sinus, etc.)?
• Have you not been sleeping well?
• Are you under unusual physical or emotional stress?
• Have your symptoms started within the last 24 hours?

If MS flare-up symptoms are similar to before but worse with an illness or stress, it’s likely a pseudo-relapse. 

A pseudo-relapse does not require treatment. But we may want to run tests to rule out an infection. You’ll likely feel better with self-care, including rest and drinking plenty of fluids.

If you answer yes to any of the below questions, you are likely having an inflammatory MS relapse:

• Are symptoms persistent or worsening over 48 hours?
• Have lab tests ruled out an infection?

In the yellow zone, MS relapse symptoms are mild and typically ones you’re familiar with. Some patients do not find them bothersome enough to seek treatment. But if relapse symptoms interfere with daily activities, you should see one of our MS specialists. We perform an assessment to determine whether you may benefit from steroids or monitoring, and re-evaluate your relapse prevention plan.

If you answer yes to any of the below questions, it is likely an MS relapse that can benefit from prompt attention:

• Has it been more than two days but fewer than 14 since symptoms have peaked?
• Are MS relapse symptoms severe enough to prevent you from completing everyday tasks?
• Do you feel certain it’s an exacerbation or that symptoms are worrisome enough that you’d like to be seen? 

Steroids enable you to feel better sooner and make a more complete recovery. If they are appropriate, we arrange for you to receive a high dose by mouth. In select cases, an infusion (through a needle in a vein) is more appropriate.

At your appointment, we explain your diagnosis, discuss how therapies work and address any concerns you may have. You can get started by reading our multiple sclerosis FAQs.

Our specialists care for patients across the Puget Sound area and beyond. Find an MS specialist near you.