MS pseudorelapses: smoke and mirrors?

Sometimes, it can feel like you're having a relapse... only you're not! A pseudorelapse occurs when outside factors, such as hot temperatures, stress, or infections, cause MS symptoms to temporarily get worse. Pseudorelapses are also called pseudoexacerbations.

Pseudorelapses are often mistaken for MS relapses, but there are some important differences between the two. Pseudorelapses are caused by outside factors (such as temperature, stress, and illness), while relapses are caused by the underlying disease. With a relapse, there is new inflammation in the brain. With a pseudorelapse, there isn't. Pseudorelapses last for 24 hours or less, but relapses last longer, often for days or weeks. Pseudorelapses may happen frequently and close together in time, whereas relapses happen at least one month apart. And having pseudorelapses does not mean that your disease is getting worse.

So when your MS symptoms flare up, how do you know whether it's a relapse or a pseudorelapse? There's no way to tell for sure. But you can try to figure out whether you've been exposed to anything that could make your symptoms worse, such as:

  • heat – hot baths, hot tubs, or a day at the beach, for example
  • stressful situations – experts don't universally agree about the effects of stress, but many people with MS find stress makes their symptoms worse
  • an infection – which means you may also feel ill and have other symptoms such as nausea, vomiting, fever, or chills

Urinary tract infections (UTIs) can often bring on a pseudorelapse. If you feel a burning sensation while urinating, have an increased need to urinate, or are urinating more often, you may have a UTI.

If you can't pinpoint a cause, your symptoms have lasted more than 24 hours, or you are concerned about your condition, see your doctor to find out what's going on.

What can you do about pseudorelapses? Since pseudorelapses are caused by outside factors, such as temperature, infections, and stress, protecting yourself from these things can help prevent a pseudorelapse. Every person with MS is different, and it's important to get to know which things can trigger a pseudorelapse for you. This way you can avoid them or try to minimize the effect they have on you.

When you have a flare-up, try removing these triggers first. If you're out in the sun, go inside and cool down. If you think you might have an infection, see your doctor for diagnosis and treatment. If you're under stress, try to remove yourself from the stressful situation and give yourself time to relax. If the symptoms don't go away within a day, or if you are worried about your condition, contact your doctor.

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