Pseudo Exacerbation

So for the past 3 days, l have been trying to read about this. And between my luv for you all, looking for a snow bank to bury my boyfriend, cleaning, my neighbor who took her cast off to early and a daughter who seems to have midnight anxiety attack nighty. I can't find time.

So who had, has it, what is it, how do you tell the difference? Thank you Peter_H for bringing this up


23 Replies

  • Jesmcd2 , it sounds like you're having a time of it. I'm sorry to hear that. ( And I can't help with the snow drift ... 70 degrees won't support it. )

    Pseudo-exacerbation vs exacerbation. According to my neuro, a pseudo-exacerbation is generally a flare up of an old symptom or possibly something new that lasts no more than 48 hours. There's often an external trigger, such as stress, heat, or over doing an activity.

    A true exacerbation could be an intensifying of a current symptom or something new that lasts more than 48 hours. Definitely contact your neurologist.

    I'm not a medical anything, so your best information should come from your own care team. My neurologist's clinic has several knowledgeable nurses and PAs I can contact, and get a response within a few hours.

    I hope your life settles down quickly and that you're not experiencing a relapse.

  • It doesn't last for a few days in my warrior's case… She's been in rehab for over a month and still has a week or 10 days to go. 😣

  • I'm sorry to hear about your loved one's relapse, Peter_H. I hope she's improving in rehab. Positive thoughts and prayers for both of you.

  • My neuro says my chronic UTIs set off pseudo-relapses. Seems like a full on relapse, but it isn't.

  • I pray you won't have so much to deal with! I'm sorry you're having so much extra stress.

  • I know of a snowbank near here! I've been told Jimmy Hoffa may be close by! Hahaha! Please take care of YOU! Too many times I take of everyone, but me!

    Again, you aren't alone, my daughter had night terrors when she was a toddler, now she has many anxiety attacks. Poor thing decided to take after me. Haha?

    I'd love to know what Pseudo Exacerbation is! Please do tell!

  • Jesmcd2, I found this online at I hope it helps you. :)

    What is an MS Relapse Versus a Pseudo-exacerbation?

    Lisa Emrich @LisaEmrich Health Guide

    Relapsing forms of MS such as relapsing-remitting MS (RRMS) and progressive-relapsing MS (PRMS) are characterized by unpredictable episodes, called relapses or exacerbations, of acute worsening of neurologic function which may involve new symptoms or a worsening of older symptoms. With RRMS, relapses are typically followed by periods of partial or complete recovery, or remission.

    For an attack to be consider an MS relapse, it must meet the following criteria:

    New symptoms appear or old symptoms of MS become worse

    Episode of new or worsening symptoms lasts for more than 24 hours

    Symptoms of the relapse do not occur within 30 days of a previous relapse

    There must be no other explanation of the symptoms

    Many people with MS who are heat sensitive may experience a temporary worsening of symptoms when the weather is very hot or humid, sunbathe, get overheated from exercise, or take very hot showers or baths. Some people may notice that their vision becomes blurred when they get overheated—a phenomenon known as Uhthoff's sign. Even a slight elevation in core body temperature of one degree can cause a temporary increase in MS symptoms.

    These temporary changes in symptoms are called pseudoexacerbations which look like and act like real relapses, but are temporary and do not indicate disease activity or progression. Realize that when we talk about pseudoexacerbations, we are certainly speaking of very real symptoms as there’s nothing “fake” about the experience; it is just temporary. Common triggers that may cause a pseudoexacerbation include infection, especially urinary tract infection, stress, pain or fatigue, exposure to heat or cold, premenstrual syndrome, or certain medications.

    It is also possible to have symptoms which are due to an underlying medical condition, such as a thyroid problem, a vitamin deficiency, migraine headaches, or anemia, rather than MS; but it can be hard to tell the true cause. For instance, you might think that vision changes are related to your MS, but in fact they may be caused by migraines.

    To avoid pseudoexacerbations, try to eliminate exposure to possible triggers. To treat a pseudoexacerbation, treat infections, reduce stress, use strategies to keep cool (or warm), and discuss potential underlying medical problems with your doctors.

  • This is a fantastic explanation! I have frequent pseudo-exacerbations due to heat - I live in SC. My vision really suffers. Rest and cooling off help relieve the symptoms.

    We don't have snow banks in SC, but we do have lots of alligators and pig farms. Digestion removes almost all forensic evidence! :)

  • cindyrn68 😁 very true about the alligators and pig farms.😁 As long as you burn the clothes, it's all good. Now, how to get him down there. 😕 😅 I do have to remember how long digestion takes tho, l have to have us accounted for you know😅😅

    What do you do to get relief from the heat? I will share any hints l can take!

  • dmaskal1 migraines can change your vision?

  • I should have reference where I got my post was so if I were you I would send that question to Lisa Emrich @LisaEmrich for a detailed response.

    Nevertheless, yes I do believe migraines can change your vision.

  • dmaskal1 lm sorry 😅 my mind races Sometimes and doesn't finish the thought until later in the day😕 Go figure. Since it's actually been awhile since I have had a migraine. Thank goodness! I have heard of some people seeing an "aura" and lm light sensitive. So would make absolute sense to me. Now if l feel it coming on, l have a med that l can take.

    How are you btw? You were missing for awhile. Don't think l didn't notice.☺


  • So you noticed did you? :) I've been trying to get organized and start writing again. So I haven't been keeping up with HealtUnlocked on a daily basis recently. Sorry. :(

  • Ah no worries dmaskal1 , what are you going to be writing? And of course you were missed. It might take me awhile to figure out that someone is missing, but l get there, sometimes.😅

  • jesmcd2, I’m writing to encourage people to replace the paradigm of economics and capitalism, in which people are destroying life in ecosystems and natural resources which constitute Earth’s life support system, with the paradigm of nursurlifres, i.e., NURturing the SURvival of all forms of LIFe and natural RESources in which people will help maintain the health and survival of all life and natural resources on Earth and thus maintain Earth’s life support system.

  • Sorry, l should have clarified, lm not having a relapse.😊 This is normal everyday life for me? Just the snow is not helping me here😑 l am going to need a shovel though? And could you make sure your prints are on it for me😁

    OK back on point here. So basically, after 24 hrs get ahold of your Neurologists and let them figure it out. But l don't understand, why they wouldn't call it a true relaspe, if it lasts longer than that. I guess that's where lm confused. Why so many labels?

    Eleyne92 Peter_H greaterexp jennie62 dmaskal1 and Tutu where have you been hiding? You have been missed!


  • Jesmcd2 Thank you for starting this thread. Not until reading the replies did I understand the difference between an exacerbation and a pseudo exacerbation. Though I have been accurately diagnosed and have the lesions to prove it, all my exacerbations are pseudo with the exception of those on the optic nerve, and the trigeminal neuralgia. What a puzzling disease this is! No wonder it has taken so long to treat it appropriately; it is different for every one of us.

  • goatgal l had no idea it even existed. I should remember myself that this really IS an ever changing, forever learning roller coaster ride.😕☺ Like you l have the lesions, and God Forbid it ever becomes a contest, like you say for some people, getting a DX takes forever. I would have never known if it hadn't literally kicked me in the face.

    I do know heat affects me bad now, which makes me very very sad. I so love to sit in the sun! I can feel all the pain in back release, with no pain meds. But sitting out will make me sick to my stomach, so tired and then the eyes start, then the legs go, it's not pretty. I just figured it was normal.😅😅

  • Well, my warrior, finally, got her tentative release date from rehab. It looks to be February 18th. that will end 3 nights in the hospital and 50 nights in rehab. It's been a long siege this time.

    Remember, every case is different. One person's pseudo-exacerbation can (and will) be different from everyone else's.

  • Peter_H that's Wonderful News!!! Tell her we are ALL Cheering for her! And we can't wait to meet her!!!


  • Much to my pleasant surprise, yesterday they moved it up to February 11th! Guess I better get cuttin' and start getting some food in the house. Had to get a new stove/oven while my warrior was in rehab, and, other than to make sure all burners and the oven worked, I haven't turned it on! These next two weeks will definitely be interesting as we discover what the new normal is... and if we can keep it at this level. Now I have to become physical therapist (pronounced "terrorist") and work her hard to keep her at the level she has gained back... as well as being the chief cook and bottle washer in the house.

  • As a caregiver Peter_H ,you have a whole different perspective of our situation. And l can understand the word "terrorist" grrrrr my boyfriend tried that once😅😅 Like l said once😑

    I'm so glad your wife is coming home!!! Even earlier than expected! And before Valentine's day!💕 She must be just as excited!

  • Peter H, I know you can do it; while making sure what you do meets her approval. :)

You may also like...