Multiple sclerosis

Multiple sclerosis (MS) is a non-contagious chronic disease of the brain and spinal cord characterized by a variety of neurologic symptoms caused by demyelination of neurons. Multiple sclerosis results from attack by a patient's own immune system on their central nervous system and is thus categorized as an autoimmune disease.

Factors triggering a relapse

Relapses are often unpredictable and can occur without warning with no obvious inciting factors. Some attacks, however, are preceded by common triggers. In general, relapses occur more frequently during spring and summer than during autumn and winter. Infections such as the common cold, influenza, and gastroenteritis increase the risk for a relapse. Emotional and physical stress may also trigger an attack, as can severe illness of any kind.

Related Topics:
Common cold - Influenza - Gastroenteritis - Emotional

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Heat can transiently increase symptoms, in something known as Uhthoff's phenomenon. This is why some patients avoid saunas or even hot showers. However, heat is not an established trigger of relapses.

Related Topics:
Uhthoff's phenomenon - Sauna

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Pregnancy can directly affect the susceptibility for relapse. The last three months of pregnancy offer a natural protection against relapses. During the first few months after pregnancy, however, the risk for a relapse is increased 20-40%. According to current knowledge, pregnancy doesn't seem to influence long term disability. MS does not increase the risk of bearing a handicapped child.

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Many potential triggers have been examined and found not to influence relapse rates in MS. Influenza vaccination is safe and does not trigger relapses as demonstrated in several recent studies. It can therefore be recommended for MS patients, especially for those at risk for influenza (e.g. healthcare workers). There is also no evidence that hepatitis B, varicella, tetanus, or Bacille Calmette-Guerin vaccination increase risk for relapse.

Related Topics:
Vaccination - Evidence - Hepatitis B - Varicella - Tetanus - Bacille Calmette-Guerin

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Statistically, there is no good evidence that trauma or surgery trigger relapse. In principle, surgical procedures require no special precautions if not dictated by existing disability. Participation in sports is possible, although extremes, such as marathon running, should probably be avoided.

Related Topics:
Trauma - Surgery - Sport - Marathon running

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