confused

[fatigued]

I had a bout of ON that is getting better, but noticed some old symptoms return of mine (like one after the other) but they are lasting just a few hours at a time. What is this? Can the inflammation in my CNS be causing anything to flare up temporarily?

[jreagan70]

Hi fatigued:

Those short episodes of increased symptoms are not due to inflammation and they are not attacks. They're due to normal variations in body temperature and body chemistry that affect how efficiently (meaning not efficiently) the electrical signals along your nerves are being transmitted.

You asked the the same question before under another thread. Copied below is the answer I posted for you then.

I know a true relapse is meant to be over 24 hours but what about shorter attacks (minutes or hours)

Hi fatigued:

Those shorter episodes are not attacks. That's a very important distinction.

The symptoms occur because the electrical signals going through the nerves that have damaged insulation (myelin) aren't transmitted effectively when body temperature rises. The temperature doesn't even have to go up by very much. The transmission of the electrical signals is still interrupted, and that's what causes the symptoms.

When that happens, there are no immune system cells or components activated. There is no autoimmune attack, and no damage to the nerve cells is occurring. That's why these events are called pseudo (false) exacerbations.

In a true attack/flare/exacerbation/relapse, components of the immune system chemically damage, destroy and/or eat myelin, which can also cause damage to the underlying nerve cell itself. It really is an attack. None of that happens in a pseudoexacerbation.

In a pseudoexacerbation, the symptoms resolve when the temperature goes back down. That's why they can resolve in minutes or hours.

In a true attack, it takes the body days to weeks to months to never to repair damaged myelin. It doesn't (can't) happen in minutes or hours. So the symptoms of a true attack take many days to weeks to months to never to resolve, not minutes or hours.

[DPL2014]

Thanks!

I'm really glad fatigued asked this question because I had been wondering the same thing and was going to ask today.

my husband and I hiked 10 miles yesterday and then went to the movies about an hour later. Once the lights went down for the movie I got a light show out of my left eye that no one else could see. Auras everywhere...flashing every time my eyeball moved... Today it's all gone. In fact, it was gone when we left the movie, though it did return intermittently in the evening when I went in dark rooms.

i was kind of freaked out that exercise might be causing more optic nerve damage...which would REALLY STINK since they tell us to keep moving with MS. Jreagan's answer eases my mind a lot. Will still bring it up at my neuro appt on Tuesday, but I slept well last night knowing that exercise doesn't cause real exacerbations. Thank you both!!!

[fatigued]

Thanks for replies.

jreagan70, yeah I think I know what you mean about pseudoflares. Thing is, I have had some blurriness when hot before then it went away.

I guess I am feeling down right now because some really old symptoms have kind of cycled (like one after the other for a few hours each) ever since I got this new bout of ON. I've read on the internet this has happened (like if the new inflammation has occured near old lesions) but cant find that much literature on it, just wondered if this is common on this forum thats all.

MS keeps screwing with my mind. I feel that when I have a new exacerbation it can bring up older symptoms and makes me feel down. You know?

[jreagan70]

Hi fatigued:

Yes, I think I do know. And because I do I want to propose something.

It isn't MS that's screwing with your mind. It's your anxiety about your MS that's screwing with your mind.

Anxiety magnifies symptoms by about 1000%. It makes people look for trouble that isn't there. Anxiety makes people disregard what's true and logical and drives them into an unrealizable search for explanations for the imagined and untrue. And when what they're seeing doesn't validate what's imagined and untrue, and they can't find something that does, they just become more anxious. And that really sounds like what's going on with you.

The good news is that your anxiety can be treated and managed with therapy and medication. When you get your anxiety under control, your life will get so much better, even with MS. No matter what's going on with your MS, MS without anxiety is better than MS with anxiety.