Pseudo-Exacerbations in MS: Grounded in Reality

The word “pseudo” can be very misleading. The dictionary defines pseudo as “pretend; false or spurious; fake, artificial, sham; not actually, but having the appearance of.”

In the case of MS, you can disregard the words pretend, false, spurious, fake, artificial, and sham. A pseudo-exacerbation is not an imaginary event or a psychological disorder. It is not a cry for attention, and most assuredly is not fake.

It is not actually, but has the appearance of an exacerbation — along with all the very real physical symptoms. A pseudo-exacerbation is a flare-up of symptoms caused by another medical event or stressor, such as a urinary tract infection, fatigue, flu, or a simple case of elevated body temperature. Unlike a bonafide MS exacerbation, no neurological damage is taking place, which is great news in the long run, but doesn’t make its presence any easier to bear.

An MS exacerbation, or relapse, can cause new symptoms or progression of the disease, generally lasts anywhere from a few days to several months, and is caused by inflammation in the central nervous system. Damage to myelin disrupts the transmission of nerve impulses, causing the wide variety of symptoms associated with MS. Particularly severe relapses may cause permanent damage, prompting many doctors and their patients to choose steroid treatments in the hope of shortening the attack and avoiding long-term damage.

Pseudo-exacerbations generally are not treated with steroids, but may point to underlying health problems that need to be addressed. The cause of a pseudo-exacerbation may be something as innocuous as a little too much summer fun in the sun, but repeated attacks could be a sign that something else is wrong, and calls for further investigation.

Too many of us have a tendency to dismiss any and all physical symptoms as being MS-related. Ignoring glaring warning signs such as repeated pseudo-exacerbations could be a serious mistake. The problem is that it is often impossible, without diagnostic intervention, to know if a true relapse is taking place.

Whether it is a classic exacerbation or a pseudo-exacerbation, the symptoms are very real to the patient, and can have a devastating impact on daily life. Far too often, people with MS are accused of exaggeration or outright faking of symptoms.

Don’t let the word pseudo fool you. You are well-grounded in reality. It’s just part of the package that comes with multiple sclerosis.


Linda Grace Cox
Linda Grace Cox4 years ago

I returned last night from a 10-day road trip starting with my daughter's college basketball trip and ending with a mini- family reunion and had a total blast! By day 9 I was having a HARD time getting around and by day 10 I couldn't even climb into bed without assistance! My first thought this morning was to get a mega-dose of Solumedral then I remembered reading about pseudo-exacerbations. I googled it and you are what I found! Thank you! Looking over the past 10 days I didn't exercise once, drink enough water, take the regular cat-naps that are an important part of 'my new reality' and I'm feeling the consequences!