Definition of an attack in MS?

[msindian32]

Hi,

I am new to MS, recently diagnosed in May,2015. I had slight pain in legs and fatigue for last one year but after my lumbar puncture, I started seeing lot of symptoms like double vision, lot of fatigue, numbness etc. On May, 28 I started 5 day of Solu Medrol but no benefit even after that. My disease is not getting better with Steroid also and its getting worse or worse.

I wanted to know is this an attack or I am having progressive MS. Is attack usually subside with IV Steroid? Or If its an attack then ussually how many days it takes to phase off.

[Mamabug]

It is likely an MS attack, in my opinion. Symptoms do often subside with solumedrol, but, for me, it can often take three weeks before I see results. My 5 day course of steroids is usually followed by a 10 or 12 day taper. But, I'm usually all of the way off of steroids for awhile before my relapse symptoms go away.

It is possible, too, that, following an attack (relapse), not all of your symptoms will disappear. Even in RRMS (relapsing remitting multiple sclerosis), our disease progresses and residual symptoms sometimes remain.

However, if, after one month, it is not only not improving, but getting worse, the steroids might not be helping. That happened to me, once, when my doc experimented with trying a lower dose of oral steroids. When she increased it, eventually most of my symptoms went away.

I'm not sure what's going on with you, but I would encourage you to contact your doctor's office and let them know that symptoms are getting worse, rather than better.

[msindian32]

Thanks for your response.

I missed to mentioned Steroid details, I got 5 days of 1000mg Solu-Medrol and tapering (60-60-50-50...) of prednisone. No effect at all.

Day before yesterday my doctor tried one infusion of Cytaxon (400 mg) + 1000 mg Solu Medrol as I haven't shown any improvement with IV Steroid. I dont know whether this decision was bit early or he doesn't want my condition to get worse.

I will wait for a week to see its impact. Today, I started having pain in left ear and left face. Numbness faded out.

Actually, I was scared because if the symptoms are not going away from steroid then I might have PPMS.

It is likely an MS attack, in my opinion. Symptoms do often subside with solumedrol, but, for me, it can often take three weeks before I see results. My 5 day course of steroids is usually followed by a 10 or 12 day taper. But, I'm usually all of the way off of steroids for awhile before my relapse symptoms go away.

It is possible, too, that, following an attack (relapse), not all of your symptoms will disappear. Even in RRMS (relapsing remitting multiple sclerosis), our disease progresses and residual symptoms sometimes remain.

However, if, after one month, it is not only not improving, but getting worse, the steroids might not be helping. That happened to me, once, when my doc experimented with trying a lower dose of oral steroids. When she increased it, eventually most of my symptoms went away.

I'm not sure what's going on with you, but I would encourage you to contact your doctor's office and let them know that symptoms are getting worse, rather than better.

[Mamabug]

Good to hear you are in touch with your doc about the no improvement.

Your 1000mg dose, followed by a taper, is the standard really high dose for serious flares. I used to have those regularly, but, since I switched DMD's (disease modifying meds), I can get by with starting with 80mg now. She tried less, last time, but less was too low for me.

I don't know what else to tell you. PPMS is fairly rare, so I wouldn't jump to conclusions. Just stay in touch with your doc and hopefully something will work for you. Maybe some flares just take longer than mine do to respond to steroids; i don't know.

Sorry to hear about the awful stuff you are going through.

[SNOOPY]

Hello msindian32 and welcome to MSWorld.

It's been almost a month since you had IVSM. Whatever benefits you would have seen should have been noticed by this time.

Steroids are used for exacerbations (attack, flare-up, relapse). Some exacerbations do not require steroids and even if steroids are used they may or may not help. It is possible to improve without the help of steroids. Sometimes an exacerbation simply has to run it's course.

It is important to understand that remission in MS is either complete (no symptoms) or partial (residual symptoms, symptoms come and go). Partial is the most common. Many of us live with daily symptoms of some sort

No symptom should be considered permanent for at least 2 year and some have even seen improvement beyond that time frame. If nothing else, this disease does teach you patience

What you might discuss with your Neurologist is symptom management medications for specific symptoms that are difficult for you to deal with. Your fatigue can be treated with medications such as; A.D.D. medications (Ritalin, Adderall, ect), Provigil or Nuvigil.

Exercise has been shown to help with fatigue as well as pain and spasticity. Exercise should be done very slowly and increased very slowly. Doing too much too fast is not good.

Have you been referred to an Ophthalmologist or Neuro-Ophthalmologist regarding your double vision? If not, please speak to your DR. about a referral to one.

Steroids typically don't help with sensory symptoms such as numbness.