I just wanted to mention and/or clarify a some points regarding the hug/spinal lesions, for those who have this to contend with (and want to know the nitty gritty).

Of course “nothing is absolute” with this disease, but my neuro has provided me with some awesome written material about spinal lesion attacks. I have gone through most of what I have read, so I suspect her advice would ring true in most cases of spinal lesion attacks.

I'll try to give my interpretation, based on what I know/have gone through . . .

1. Apparently about 75% of PwMS have spinal lesions, but most people will never have any attacks from them. Just because we have them, doesn’t mean they will be bothersome (same as brain lesions), or will effect us more then once in a lifetime.

2. If we have an attack from them, it can be mild, moderate or severe. I imagine that full body numbness, with paralysis and internal organs affected, would be considered severe; mild would be only one large part of the body (like the hug, but it doesn’t feel “mild” at all!); moderate would include the in-between.

3. Spinal lesion attacks are a distinct neurological event, and the attack “process” is the same (for me) each time; inflammation/escalation (symptoms getting worse) --> stabilization/status quo (symptoms remain the same) -->, repair/recovery (symptoms improve). The recovery process often follows the exact pattern of how the numbness came on, i.e. we improve first in the places where the numbness came on.

NOTE: The symptoms aren’t necessarily just altered sensations (pain, numbness, shocks), bladder/bowel issues, etc., but can include the excessive brainfog, fatigue, spasticity, back aches, headaches, motory problems, etc. too.

4. The process almost always takes 4 – 6 weeks of escalation/status quo, then 4 – 6 weeks of recovery. If the symptoms/damage does not start to recover by the 3rd to 6th month, the damage can be permanent. BUT if we do make some recovery by that time, we may continue to make additional recovery over the next two years.

Sometimes the process will be shortened by the use of steroids, but then it will repeat itself . . . (see below).

5. Steroids are not normally rx’d with sensory/spinal lesion attacks because there is no evidence that they help in the short or long-term (plus there are short and long-term side effects from the use). No clinical trials have ever proven their effectiveness for this type of attack...

(Utilization of steriods is personal choice, of course) but it is my experience that this type of attack will run it's course whether or not steroids are used. Steroids (seem to only) slow down that natural inflammation process, then the attack regains it’s momentum and continues to do what it’s gonna’ do eventually anyway.

Apparently pulse steroids may help longer-term "damage" . . .

6. The (ultimate) damage caused during this kind of attack (dependant on the severity of the attack when it occurs), is:

- 33% of the time (lesions heal, no permanent damage)
- 33% of the time (lesions partially heal, some substantial permanent damage)
- 33% of the time (lesions don't heal adequately, bedridden/wheelchair bound or severely disabled from the get-go).

With spinal lesions, sometimes patches of numbness, or the hug, will suddenly come on in various parts of our bodies, even though we are not officially in a spinal lesion attack (pseudo exacerbation). This numbness can be as a result of an increase in temp, fatigue, stress, infection, sickness, etc. . . . but once the trigger is removed the symptom will settle back down.

However, in the case of pseudo exacerbations caused by infection, this can lead to a real attack if the infection is not treated.

It is usually abundantly obvious if this is a “real” spinal lesion attack by the extent of the altered sensations. Even a “mild” attack is often painful, and includes a substantial part of the body (torso and/or legs and/or both hands/feet, etc.). A numb “patch” would not be considered an attack, but may be a warning sign to be checked for infection . . .

As for the “hug” specifically, this sensation (although it might not be called the same thing) can happen anywhere, not just in the torso area. For instance, I have had “the hug” sensation in my legs and feet too.

Cherie