Multiple sclerosis is an autoimmune disease that mainly affects the brain, the spinal cord and the optic nerves. It is twice as common in females as it is in males. It does not have any age preference. It can occur at any age, but mostly it is seen in the adult age group. It is more common amongst the people who live in the temperate climates.
The nerves are protected by a covering of fat called as the myelin and this myelin sheath is destroyed by the immune system by the process of autoimmunity. Hence, the nerves get damaged and this causes hampered functioning of the nervous system.
What Is Multiple Sclerosis Attack?
A multiple sclerosis attack is also called as multiple sclerosis flare up or multiple sclerosis relapse or MS exacerbation. MS attack involves occurrence of either new symptoms of multiple sclerosis or worsening of old symptoms. MS attack is different for every patient. Everyone shows different symptoms and signs due to MS attack. (1)
Multiple sclerosis attack is seen because of inflammation occurring in the central nervous system. Due to this there is damage to myelin and this leads to disrupted transmission of signals or nerve impulses.
Signs that may point towards multiple sclerosis attack-
- Problem in concentrating or focusing
- Problem while coordination and balancing
- Difficulty in remembering or poor memory
- Difficulty in vision
- Tingling sensation (needles and pins sensation)
- Problems with bladder functioning
- Reduced mobility
Following criteria must be fulfilled for the symptoms to be included under multiple sclerosis attack-
- There is evidence of increased severity of previously present symptoms
- New symptoms have been experienced
- At least 30 days have been passed since the previous relapse had occurred
- The doctor has ruled out other causes of exacerbation like stress, heat, etc.
A multiple sclerosis attack usually occurs due to the presence of a triggering factor. Some of the common triggering factors are-
Vitamin D Deficiency– Decrease in the levels of vitamin D in the body of patients with MS can lead to an MS attack. Due to this reason, the level of vitamin D must be monitored regularly and proper supplementation must be given as required.
Infection– Certain bacterial or viral or fungal infections can trigger an multiple sclerosis attack. Patients must be advised to take steps to reduce the chances of infection for example they must be advised to stay away from people who have cold so that they do not catch it.
Vaccination– Vaccines that include live pathogens for example the vaccines of yellow fever and shingles must be avoided in patients with MS. These vaccines may act as triggers for causing MS exacerbation or MS attack.
Treating A Multiple Sclerosis Attack
The patients who have mild symptoms of multiple sclerosis attack may not need any treatment and the symptoms may resolve on their own.
The severe cases of exacerbations need proper medical care. Medications used in severe cases are intravenous or oral methylprednisolone. It is a corticosteroid and it helps by reducing the immune response of the body. One more option available to treat patients with severe exacerbation is plasmapheresis. Plasmapheresis is also known as plasma exchange. In this method, the plasma from blood is separated and then it is mixed with albumin, which is a water-soluble protein, and then it is re-introduced into the body after mixing.
Severe multiple sclerosis attacks must be treated with the help of medications as well as rehabilitation techniques. Rehabilitation helps the patient to improve and restore the body functions. Problems with mobility, dressing and performance at work and at home, fitness, personal care, etc. are improved through rehabilitation. The rehab team includes occupational therapists, physical therapists, cognitive skills specialists, language therapists, etc. all of these specialists work together to improve the over all quality of life of the patients who suffer from multiple sclerosis.
In order to prevent MS attacks, the patient must be given disease-modifying drugs. These drugs are very helpful in reducing the number of relapses and also reducing the severity of the disease. They also help in delaying the progression of any disability and also help in reducing the development of new lesions in the brain or spinal cord.
A multiple sclerosis attack is basically also known as a flare-up or exacerbation. Multiple sclerosis attack occurs due to variety of reasons and some of them are infections and vitamin D deficiency. When the attack is mild or less severe no specific treatment is needed. If the attack is severe then proper medical care is needed. Medications can be given along with rehabilitation therapies. Preventive measures can be taken to reduce the chances of relapse and multiple sclerosis attacks.
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