How Severe Are Attacks Of Multiple Sclerosis (MS)?

The manifestations of MS are often mild and transient but less commonly may be severe. Shortly after the discovery of MS as a disease in Paris, Uhthoff, a Vien-nese physician, found that increases in body temperature could temporarily result in blurred vision in a young man who had recovered from an attack of optic neuritis. This (“Uhthoff ”) phenomenon can also result in other symptoms occurring transiently (or as long as body temperature is increased).

It is important to know that these increases in symptoms brought out by ele-vating body temperature are not attacks of MS. However, if the same symptoms occur in the absence of a fever or elevated body temperature, they may be mild attacks of MS. Attacks of MS can sometimes be severe and require a prolonged period of recovery lasting as long as a year or so, but this is unusual. ACTH and high-dose intra-venous (IV) steroids shorten the period of recovery; however, many attacks are mild, and treatment is not needed.

Fortunately, effective treatments (high doses of  interferon-beta, Betaseron, or Rebif ) for MS reduce the risk of these severe attacks more than milder attacks. In the studies that led to Food and Drug Administration (FDA) approval, interferon-beta reduced the frequency of severe attacks by almost 50% as compared with a 30% overall reduction. This is more meaningful when you realize that severe attacks are associated with an inability to function and are usually treated in hospital.

Karen’s comment:

Closely correlated with the maxim “if it is a symptom, it is probably MS” is “if it is an MS symptom, it is not necessarily a new attack.” MS is finely balanced and disrupted by medications and changes in my body. Things that seem straight forward or completely unrelated to MS may affect MS and require input from the neurologist. I have learned to ask Dr. Sheremata if he approves of something I want to do. The answer is sometimes yes, sometimes no, sometimes if you must, and sometimes the glasses are lowered and a look of disbelief crosses his face!