High grade fever and MS

[Waydwnsouth1]

I've heard different things about this topic so I thought I look for some more opinions.

Is a high grade fever, 100 and higher dangerous for an MS patient?

[jreagan70]

Hi Waydwnsouth1:


In addressing your post, the first issue we have to get past is that you’re looking for opinions and not for facts. As the saying goes: You’re entitled to your own opinion, but you’re not entitled to your own facts.

The second issue we have to get past is that your post is based on at least one incorrect premise. And an incorrect premise leads to an incorrect conclusion.

So for anyone who is interested only in opinions, you should stop reading right now.

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We have to address the incorrect premise that 100 degrees F is a “high grade” fever. 100 degrees is not “high grade.” It’s the temperature at which fever begins. Normal human temperature varies throughout the day and various circumstances, up to 100 degrees. So 100 degrees isn’t high; it’s actually the low end of the temperature range for fever.

Along with that goes an incorrect belief a lot of people have that anything between 98.6 and 100 degrees is a “low grade” fever. That’s also within the range of normal temperature variation. So even if the temperature remains elevated for awhile and is above the person’s usual average temperature, it isn’t a “low grade fever.” Medically, a low fever is about 100 or 101 degrees. And that’s a generic term. There isn’t a definitive scale for this.

The higher end of temperature for fever is different, because physiological changes begin to happen, and those changes do set a marker for high. Physiological changes begin at about 104 degrees F.


The other term that has to be defined is “dangerous.” Dangerous in what way?

The fast answer is that high body temperatures are physiologically no more dangerous to people with MS than to anyone else. What makes high body temperature more dangerous to some people with MS is that the pre-existing effects of MS might make them unable to physically get up and access medications or cooling devices to bring their temperature down to a safer level or to summon help. It isn’t the temperature that’s dangerous. It’s the possible inability to perform actions to bring harmful temperatures down that’s dangerous.
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In regard to temperature, there is no difference between high fever and heatstroke. The effects of temperature are the same. The difference between them is what caused them. In fever, the increase in temperature is caused by trying to fight off a foreign invader. In heatstroke, the increase is caused by outside temperature raising body temperature.

The only thing that physiologically might make a fever more dangerous – to everyone, not just people with MS – is the effects of whatever the foreign agent is.

Foreign agents aside, there is NO physiologic difference that makes high body temperature, whether from fever or heatstroke, more dangerous to a person with MS than to anyone and everyone else.

There is no known difference in the effects of increased temperature on nerves that have been demyelinated by disease vs. normal nerves in everyone’s body that normally are not covered by myelin. Much of the nervous system is normally not covered in myelin.

And this is important: This is the current difference between fact and opinion. Everyone can think what they want to about this. But the opinion that heat damages demyelinated nerves in ways in which it does not damage nonmyelinated nerves is undoubtedly formed in part by being unaware that nonmyelinated nerves even exist and that they’re not affected by heat.

About 105 degrees F is the top of the temperature range at which the human body can function normally. Chemical reactions no longer occur normally and organs begin to shut down. The body’s normal cooling mechanisms can’t function. And that’s dangerous because it affects the entire body. And that’s why people die from heatstroke. But that’s the same for people with MS as it is for everyone else.

Fevers of this magnitude can also kill everyone at this point. But at this stage, many people with high fevers are under medical care, and their body temperature can be brought down, preventing temperature damage.

So in answer to part of your question: Physiologically, high body temperatures – whether from fever or heatstroke – are dangerous, but they do no more damage to people with MS than to anyone else.

This is the answer to the other part of your question, and likely what you’re looking for.

In some people with MS (and a few other neurological conditions), the normal body functions that would allow a person to get away from external causes of high temperature or to go get help in the presence of fever or heatstroke already don’t work. And that’s what makes the high body temperature more dangerous.

In people with MS, demyelinated nerves don’t allow nerve signals to transmit normally, and the functions those nerve serve can’t occur normally or maybe not at all. This is what happens in a pseudoexacerbation, and why increased body temperature in the presence of MS symptoms prevents the event from being considered a true (caused by inflammation) exacerbation.

In the case of a fever or elevated body temperature, a person with MS may not be able to physically get up get to ice, cold water or air conditioning to bring the temperature down. They might not be able to get to medication that can bring temperature down. They may not be able to get to a phone or otherwise summon help.

In people who have worsening cognitive function in the case of high temperature, they’re unable to think clearly enough to choose and perform the necessary actions to get help to bring their body temperature down.

The answer is that high body temperatures are physiologically no more dangerous to people with MS than to anyone else. What makes high body temperature more dangerous to some people with MS is that the pre-existing effects of MS might make them unable to physically get up and access medications or cooling devices to bring their temperature down to a safer level or to summon help. It isn’t the temperature that’s dangerous. It’s the possible inability to perform actions to bring harmful temperatures down that’s dangerous.

[Waydwnsouth1]

jreagan70

Thank you for very knowledgeable temperature, fever and how it correlates to MS. I know it was a rather vague question but, I asked the question as it was asked if me. So now, I can share my new found knowledge with whom ever asks.