The definition for an attack is:
“To be a true exacerbation, the attack must last at least 24 (to 48) hours and be separated from the previous attack by at least 30 days. Most exacerbations last from a few days to several weeks or even months.”
“Exacerbations are caused by inflammation in the central nervous system. The inflammatory damages the myelin, which slows or disrupts the transmission of nerve impulses and causes the symptoms of MS.”
http://www.nationalmssociety.org/abo...ons/index.aspx
Another guideline with respect to attacks includes:
“Relapses generally consist of three phases. There is a period of worsening, with onset of new deficits or increasing severity of old deficits. This is followed by a period of stability, with no change in deficits. The final phase is the period of recovery, with variable degrees of improvement in deficits. Most patients recover within six weeks, although for some, improvements can continue over months. Recovery can be complete return to baseline status, partial return, or no improvement.”
http://www.nap.edu/openbook.php?record_id=10031&page=17
“An exacerbation may be mild or may significantly interfere with the individual's daily life. Exacerbations usually last from several days to several weeks, although they may extend into months.”
http://multiplesclerosis.blogharbor....4/3478125.html
Pseudo exacerbations also have a definition and guidelines. A simple definition would be:
“A temporary aggravation of disease symptoms, resulting from an elevation in body temperature or other stressor (ex. an infection, fatigue, heat, or constipation), that disappears once the stressor is removed. A pseudo-exacerbation involves only pre-existing symptoms (flare-up), rather than new disease activity or progression.”
http://www.thjuland.net/gloss1-p.htm...o-Exacerbation
“While the symptoms are real enough, they are temporary and subside when the triggering event, such as heat, has passed."
Once the triggering event is past—e.g., the body temperature returns to normal, the symptoms subside as well.
http://multiplesclerosis.blogharbor....4/3478125.html
So, most pseudo exacerbations are very short-lived, occur as a result of a trigger, and normally clear up very shortly after the trigger is removed. The exception to this rule is if it is a result of some sort of infection. What a doc would normally do though, when we are experiencing “new . . . or worsening of existing symptoms, lasting longer then 24 hrs”, is to try to determine if we have some sort of infection. If that is the cause, it is called a pseudo exacerbation (not a new neurological event), and we would be treated with antibiotics. If it is not a pseudo exacerbation, then it is defined as an attack.
Cherie