I have been to see my MS nurse today as i have been having a worsening of symptoms new and old. He has told me that this is an exacerbation but not a relapse, i’m confused now as i thought this was the same thing.

Any advise is very much appreciated, is this good or bad news?


Essentially, a relapse is NEW symptoms which exist for more than a minimal period of time.

A flare / pseudo-relapse / exacerbation of symptoms (other terms can be used) is when existing symptoms worsen or symptoms that you have had previously that remitted come back. They can be caused by things such as infections or “extremes” of temperature or, according to some - but not all MS experts - periods of intense stress.

Just because something is a “pseudo-relapse” does not mean that it is any less serious or debilitating than a “proper” relapse - just no new “holes in your brain” as I like to think of them .

Hi Lisa

According to the National MS Society an exacerbation and a relapse are the same thing.

Several other webpages say a relapse is also known as a flare up or flares, exacerbation or attack. It would seem different people have different ideas.


i get bits and bobs ‘flare up’ on occasion, frequently due to a lack of sleep or over exercise. i rest and they are gone. this is part of life, even for those not labouring under the MS badge.

however, those symptoms which persist or progressively get worse over a course of several days, are something more significant that a temporary moment of being worn down physically / mentally and could thus be attributed to a MS source ‘relapse’.

Symptoms can be mild or severe, but i think the best measure of ‘how much they are disease related’ comes down to their duration for a single occurence.

good luck, rest up and try not to worry.