This could be rather good "news" . . .

Acute Multiple-Sclerosis relapses rarely result in permanent disability

Acute relapses in patients with relapsing-remitting multiple sclerosis (MS) rarely lead to disability, according to a retrospective chart review presented here at the American Neurological Association (ANA) 133rd Annual Meeting.

Loren Rolak, MD, Marshfield Clinic, Marshfield, Wisconsin, explained that many patients with MS fear they "might wake up paralyzed" from an acute relapse.

To assess the likelihood of severe disability from an acute relapse, Dr. Rolak examined the clinical course of 1,078 patients with relapsing-remitting MS over the last 14 years from his own database of patients with MS treated at Marshfield Clinic.

The patients in the database had a total of 2,587 attacks (mean of 2.4 attacks per patient, range: 1-14 attacks over 1-34 years). Only 7 of 1,078 patients (0.6%) had an attack that resulted in severe disability, defined as an Expanded Disability Status Scale (EDSS) score of 6 or more sustained for longer than 6 months.

Two of the 7 patients who had an attack that resulted in severe disability presented with an acute severe attack at the time of their diagnosis with MS. Of the remaining 5 patients, 2 were taking interferon beta-1b, which did not prevent the severe disability. The other 3 were not taking interferon or glatiramer-acetate therapy.

Genetic analysis failed to reveal any association between major histocompatibility complex class II DR beta 1 (HLA-DRB1) or nitric oxide synthase (NOS2A) genotypes and severe disability from an acute relapse.

Dr. Rolak concluded, "These results allow me to reassure my patients that a relapse with severe disability is extremely unlikely -- whether or not they are treated with disease-modifying therapy. Consequently, the fear of irreversible disability should not influence their decision to take interferons or other treatment."

Source: Doctor's Guide Channels (25/09/08)

http://www.msrc.co.uk/index.cfm?fuse...how&pageid=723
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Wish I could see the data on how many of those 7 had severe Transverse Myelitis (spinal lesion attacks). I'm betting most, if not all.

I guess it would help to know what is actually causing the underlying damage, IF it is not related to relapses in any way. Then again, perhaps we "appear" fully to recover (on the surface), but the underlying (but not obvious) damage has still been done by the relapse.

Overall these results seem somewhat reassuring though.

Cherie

Dumb question from noobcakes me, but what's an 'acute' relapse exactly?

What's the 'other' type of relapse (other than acute)?

Good question, Laura.

I suspect any relapse that seems debilitating to us at the time would be considered "acute", but in this study I imagine they ran into everything from having only the "having difficulty walking + sudden relentless fatigue"-type, right through to the "paralyzed from the get go"-type.

Cherie

Makes sense. My first 'true' relapse (and I say 'true', because they found me and diagnosed me in a state where I had a bunch of stuff piled up from over time) felt like that, entirely. It was literally an 'attack' of symptoms all coming back at once and smacking me in the face.

Now those have abated. Thankfully!

ok I am confused, hush... acute same as pseudo's? and if its not disabilitating, then what I dont have RRms cause i have disabilities? im so confused

I have not heard the term acute used with MS before and from the article didnt find his definition of acute ms, did I miss it? thank you Cherie

Hurumph!!! Tell that one to my body..