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Fluctuation in Symptoms & Exacerbation Information


There is a marked difference between a fluctuation in symptoms and an exacerbation (flare up). A fluctation or increase in symptoms occurs because of factors such as stress, fatigue, heat, and infection. The severity varies, and when the particular factor is eliminated, the symptom(s) revert to its usual level. Fluctuations can occur throughout the day, whereas, exacerbations last at least 48 hours. There is no need for Solumedrol (steroids) when fluctuations occur.

An exacerbation is when inflammation occurs in various areas of the body. The classification of an exacerbation is when symptoms worsen and/or new symptoms develop for a period of 48 hours. It is imperative when new symptoms develop that the patient contact their physician to schedule an appointment for neurological evaluation.

During an exacerbation, it is helpful for the patient to maintain adequate rest, moderate their stress, and keep clear of infections to help recovery.

Solumedrol is the medication prescribed to the patient during an exacerbation for a period of three to five days, usually followed by a tapering dose of Prednisone. The following is a listing of possible side effects of steroids:

Short-Term Use

  • Insomnia
  • Stomach upset
  • Heartburn
  • Allergic reaction
  • Fluid retention
  • Acne

    Long-Term Use

  • Weight gain
  • High blood pressure
  • Diabetes
  • Osteoporosis
  • Cataracts
  • Hardening of the arteries

    Steroids can be used more than once per year to treat exacerbations. However, the more frequently steroids are used, the less effective they become. While some physicians and patients opt to not treat an exacerbation with steroids, it has been shown that steroids greatly reduce the duration of an exacerbation.

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