When To Seek, And Avoid, Emergency Care For MS - Everyday Health

3 Reasons to Seek Urgent or Emergency Care

Generally speaking, there are three situations that might require urgent or emergency care for people with MS, says Brandon Moss, MD, a neurologist at the Mellen Center at Cleveland Clinic in Ohio.

“First, there are issues that are direct consequences of multiple sclerosis, specifically relapses. Additionally, side effects of certain medications used to treat MS can sometimes require urgent attention,” says Dr. Moss.

There can also be issues that are indirect consequences of MS and MS-related therapies, he says. “Most commonly, that’s going to include infectious complications, though those aren’t the only things.”

In addition to those MS-specific problems, any symptoms that could indicate a heart attack or stroke require an immediate 911 call and should send anyone to the emergency room right away, says Moss.

Your MS Provider Can Help You Decide if Urgent Care Is Necessary

“For most MS-related conditions, your MS provider's office should be the first stop if you have a question about whether or not your symptoms are severe enough to seek emergency care,” says Moss.

Even if you don’t get your doctor on the phone, you should be able to discuss your symptoms with a nurse, he says. “They have been trained to give people advice on whether emergency care is necessary.”

“However, there are other non-MS related conditions, like stroke, that could be confused for an MS relapse and would warrant calling 911 and seeking immediate medical attention,” says Moss. The key difference for stroke, he notes, is that symptoms develop quickly, typically over seconds to minutes.

When Should You Seek Urgent Care for an MS Relapse?

An MS relapse is the occurrence of new or worsening symptoms that are related to inflammation involving the brain or the spine, says Moss. “They can be in one location and produce very focal or specific symptoms related to that area of the brain or the spine, or they can be in multiple areas of the brain or the spine simultaneously,” he says.

Symptoms that temporarily worsen and subside within 24 hours are called pseudorelapses. A pseudorelapse can be caused by fatigue, overexertion, fever, infection, and exposure to heat, says Moss. He explains that a pseudorelaspe represents fluctuation in symptoms caused by the brain's difficulty coping with prior injury in the setting of stress. It does not represent new inflammatory disease activity. “Once the underlying cause of a pseudorelapse is addressed, people begin to notice a return to their prior baseline,” he says.

“If you have a relapse, it’s important to get in to see your doctor quickly, because treatment can speed recovery and limit the damage,” says Moss.

“More severe relapses could involve loss of vision, especially in both eyes, severe weakness, or poor balance that can interfere with a person’s ability to move around or their safety or their ability to care for themselves,” he says. People with this type of relapse are usually treated with a short course of high-dose steroids, he says.

Depending on the healthcare facilities in your area, even a severe MS relapse doesn’t automatically mean you have to go into the hospital, says Moss. “We try to keep people out of the emergency room if at all possible,” he says.

Many healthcare systems, including the Mellen Center at Cleveland Clinic, have an infusion center. “If we determine that a person is having a severe relapse and needs to be treated with high-dose steroids, we can give them IV treatment in our infusion center,” he says.

In some cases, a high dose of oral steroids (rather than IV steroids) can be given to treat a relapse outside of a clinical setting, says Moss.