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Answered on: 8/8/2012
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Q :
I am newly diagnosed and am confused about how long an MS attack is supposed to last. I seem to have some symptoms that come and go, depending on the week (Lhermitte's Sign, ringing in ears, pain behind the eyes), but others that have been persistent for the past 8 months (numbness in legs, fatigue, muscle spasms). I know that everyone's MS is different, but I am not sure what to expect.
A :
An MS attack – also known as a relapse or exacerbation – occurs when the immune system becomes overactive and attacks myelin, the protective coating on the nerves. Although the symptoms may be similar to ones experienced in the past, during an attack the disease is inflicting new damage, which may or may not be permanent. A pseudo-relapse or flare-up of residual ('souvenirs' from previous attacks) MS symptoms can be easily mistaken for an attack. To distinguish, health care workers look at the following factors:
- Symptoms have continued for at least 24 hours.
- There are no other factors – such as infection, unusual fatigue or hormonal fluctuations – that could cause a flare-up of existing symptoms.
To be considered a relapse, the symptoms must appear at least after 30 days of stabilization or remission from a previous relapse, and symptoms must be present on a continuous basis for at least 24 to 48 hours, though typically MS relapse symptoms last weeks. Attacks relapses usually go through three stages: acute inflammation, when the symptoms are getting worse; stabilization, when the symptoms remain the same; and repair, when the person’s condition gets better. The whole process can actually take anywhere from a few weeks to a year. If a person seems to recover but then within a month has another onslaught of symptoms, that’s considered to be the same attack.
In summary: you are right - MS can be unpredictable and everybody seems to be different or to react differently, however there are certain patterns that are somewhat common. Thus, most patients can expect stabilization of the symptoms of a relapse will happen in a matter of a few weeks to a few months. Unfortunately nobody can be more precise or predict exactly what is going to happen in MS... or in most things in life for that matter!
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