Definition of relapse in multiple sclerosis (MS)

Definition of relapse in multiple sclerosis (MS):

• a relapse is defined as the onset of new symptoms or the worsening of pre-existing symptoms attributable to demyelinating disease lasting for more than 24 hours and preceded by improving or stable neurological status for at least 30 days from the onset of the previous relapse in the absence of infection, fever or significant metabolic disturbance

• clinically significant relapse
  • any motor relapse
  • any brainstem relapse
  • any sensory relapse if it leads to functional impairment
  • relapse leading to sphincter dysfunction
  • optic neuritis
  • intrusive pain lasting more than 48 hours
    
    
• disabling relapse
  • a disabling relapse is defined as any relapse which fulfills one or more of the following criteria:
    • affects the patient’s ability to work
    • affects the patient’s activities of daily living as assessed by an appropriate method
    • affects motor or sensory function sufficiently to impair the capacity or reserve to care for themselves or others as assessed by an appropriate method
    • needs treatment/hospital admission

Reference:

• NHS England (2014). Clinical Commissioning Policy: Disease Modifying Therapies for Patients with Multiple Sclerosis (MS)