THE SCIENCE OF MS RELAPSES

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Relapses may be related to seasonal changes. For example, sunnier months mean more exposure to vitamin D, and more vitamin D means a better-functioning immune system. Some experts theorize that heat sensitivity, a common symptom for MS patients, could prevent people with MS from getting enough vitamin D. This could put them at greater risk of immune system breakdown, and eventually relapse.

Approximately 2.5 million people around the world have MS. About 85% of new cases involve an RRMS diagnosis. Multiple sclerosis is a chronic condition. This means that while it’s treatable, there’s no permanent cure.

Doctors use Magnetic Resonance Imaging (MRI) to determine if RRMS is active or worsening. They also use MRI to detect the presence of lesions. These are scars caused by the inflammation and damage (demyelination) to nerve tissue that occurs in people with MS. Lesions typically affect the spinal cord, brain, and optic nerves. They cause a variety of symptoms like headache, nausea, vomiting, changes in mood, seizures, and memory loss.

MS is an autoimmune disease. It causes the immune system to mistakenly attack the myelin sheaths surrounding nerve fibers in the central nervous system. This can cause symptoms like fatigue, weakness, dizziness, muscle spasms, difficulty walking, and vision problems.

Relapses are characteristic of relapsing-remitting MS, or RRMS. It’s the most common form of the condition, occurring in about 2.1 million people around the globe. Because relapses are the result of random nerves being attacked, they can be fairly mild and manageable, or serious enough to require hospitalization.

A true relapse is an attack that lasts at least 24 hours, occurring after a symptom-free break (remission) of at least 30 days. Relapses can sometimes last as long as six weeks. They can include the reappearance of old symptoms, the worsening of existing symptoms, or brand new symptoms.

Today, relapsing forms of MS are treated with “disease modifying therapies” (DMTs). Most are given by injection, though others can be taken orally or intravenously. Ideally, these medications prevent future relapses and help relieve existing symptoms. Choosing the right DMT should always take into account the patient’s lifestyle, the type and stage of MS, tolerance for different treatments and symptoms, anticipated adverse effects, and cost.

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THE SCIENCE OF MS RELAPSES

Image Vitamin D

Relapses may be related to seasonal changes. For example, sunnier months mean more exposure to vitamin D, and more vitamin D means a better-functioning immune system. Some experts theorize that heat sensitivity, a common symptom for MS patients, could prevent people with MS from getting enough vitamin D. This could put them at greater risk of immune system breakdown, and eventually relapse.

Image Global RRMS Diagnoses

Approximately 2.5 million people around the world have MS. About 85% of new cases involve an RRMS diagnosis. Multiple sclerosis is a chronic condition. This means that while it’s treatable, there’s no permanent cure.

Image Signs of RRMS

Doctors use Magnetic Resonance Imaging (MRI) to determine if RRMS is active or worsening. They also use MRI to detect the presence of lesions. These are scars caused by the inflammation and damage (demyelination) to nerve tissue that occurs in people with MS. Lesions typically affect the spinal cord, brain, and optic nerves. They cause a variety of symptoms like headache, nausea, vomiting, changes in mood, seizures, and memory loss.

Image Common Symptoms

MS is an autoimmune disease. It causes the immune system to mistakenly attack the myelin sheaths surrounding nerve fibers in the central nervous system. This can cause symptoms like fatigue, weakness, dizziness, muscle spasms, difficulty walking, and vision problems.

Image Relapsing-Remitting MS

Relapses are characteristic of relapsing-remitting MS, or RRMS. It’s the most common form of the condition, occurring in about 2.1 million people around the globe. Because relapses are the result of random nerves being attacked, they can be fairly mild and manageable, or serious enough to require hospitalization.

Image Diagnosing a Relapse

A true relapse is an attack that lasts at least 24 hours, occurring after a symptom-free break (remission) of at least 30 days. Relapses can sometimes last as long as six weeks. They can include the reappearance of old symptoms, the worsening of existing symptoms, or brand new symptoms.

Image Medications + Therapies

Today, relapsing forms of MS are treated with “disease modifying therapies” (DMTs). Most are given by injection, though others can be taken orally or intravenously. Ideally, these medications prevent future relapses and help relieve existing symptoms. Choosing the right DMT should always take into account the patient’s lifestyle, the type and stage of MS, tolerance for different treatments and symptoms, anticipated adverse effects, and cost.

Medical professionals have been studying multiple sclerosis (MS) for many years, but the condition is still something of a mystery. We know that MS is an autoimmune disease. We also know that MS causes the immune system to mistakenly attack the myelin sheaths that surround and insulate the nerve fibers in the central nervous system (CNS). This causes interruptions in nerve signals that are responsible for many of the symptoms of the disease. 

However, we don’t know what causes these mistaken immune system attacks. We also aren’t sure what leads to MS relapses. A true relapse — also called an exacerbation, flare-up, or attack — lasts at least 24 hours. It involves the development of new symptoms, or the reappearance of old symptoms after a remission of 30+ days. Relapses are characteristic of the most common form of MS, called relapsing-remitting MS (RRMS). 

Typically, symptoms of RRMS will worsen over time as the cycle of relapses and remissions continues. 

Today, relapsing forms of MS are treated with “disease modifying therapies” (DMTs). Most are given by injection, though others can be taken orally. Some are delivered intravenously. Ideally, an effective DMT prevents relapses.

People with RRMS usually take these medications on a regular basis. Even so, many patients eventually experience further relapses. Doctors may prescribe temporary relapse treatments to help shorten the relapse period or make symptoms less intense.

If a doctor determines that the condition is progressing, or discovers new lesions on a patient’s MRI, they may recommend changing medications entirely.

Recent research suggests that MS relapses may be related to changes in seasons throughout the year. During spring and summer, people tend to spend more time in the sun. This means they’re exposed to lots of vitamin D, an essential component of healthy immune system function. Theoretically, insufficient levels of vitamin D could cause the immune system to malfunction, leading to relapse. Another theory suggests that changes in light-sensitive melatonin levels may also play a role in triggering MS relapses. This may also be connected to a common symptom experienced by MS patients: heat sensitivity. However, it’s not yet clear how vitamin D or melatonin may interact to promote or prevent relapses, if at all.

Every patient experiences MS differently, faces unique challenges, and will need a tailored treatment plan that fits their lifestyle and personal goals. Major advances in treatment have greatly improved the chances for many patients to experience fewer relapses and less disease progression, helping them live and thrive with their condition. 

Still have questions about multiple sclerosis, its symptoms, or how it’s treated? Explore Healthline's global MS Topic Center.