Overview

If you have a multiple sclerosis (MS) relapse, you might be given steroids. This information explains what MS relapse is, and what you can expect if you take steroids.

MS relapse

MS relapse is when your symptoms suddenly become worse. This might last a few weeks or months. You may recover from a relapse and have periods of time with no symptoms. However, you may also relapse again in the future.

Symptoms of MS relapse

Symptoms can be different for everyone. They can include:

• nerve pain
• numbness
• pins and needles
• blurred, double vision, or losing vision in 1 eye
• problems with co-ordination, balance and speech
• feeling dizzy
• problems controlling your bladder or bowels (incontinence)

Relapse symptoms can be worse if you have another condition, such as an infection. Treating the infection can reduce symptoms.

Treating MS relapse

Not all MS relapses need treatment. However, if the symptoms are causing you distress or affecting your usual day-to-day activities, you might be given a steroid medicine called methylprednisolone. There are no other treatments available for MS relapse.

If you take steroids, you will be given a steroid emergency card. Carry this with you to let healthcare professionals know you take steroids in case of any emergencies.

Steroids help treat a relapse faster. But the chances of having lasting effects are the same, whether you take steroids or not. Methylprednisolone does not help to stop relapses happening in the future.

Before you have steroids

Before having methylprednisolone, you should tell your doctor if:

• you have diabetes, as steroids will increase your blood sugar levels
• you have an infection, for example a urinary tract infection (UTI)
• you have any mental health problems
• there is a chance you might be pregnant

Before starting steroid treatment, your doctor will need to make sure you do not have any infections. If you have an infection, your steroid treatment will start when the infection has cleared.

Tell your MS team about any other medicines you are taking, including those prescribed for you, any you buy from a pharmacy or shop, and any herbal or homeopathic medicines you use.

Having steroids

You can take methylprednisolone as a tablet that you swallow. You will need to take the tablets with food in the morning. You will take the tablets for 5 days. Your doctor or nurse will give you more information about how to take methylprednisolone.

You can also have methylprednisolone at the hospital, through a vein in your arm. This is called an infusion, or a drip. Your doctor or nurse will discuss with you if you need this.

Side effects of steroids

Methylprednisolone can cause side effects. However, not everyone will have them. Side effects do not usually last long.

The leaflet that comes with your medicine will have a full list of possible side effects. Your doctor or nurse will explain them, and how they might affect you.

Possible side effects of steroids include:

• changes to your mood, for example having a high or low mood, or anxiety
• having an increased appetite (feeling hungrier than usual)
• headaches
• muscle pain
• a faster heart rate than usual (palpitations)
• a taste of metal in your mouth
• a high blood sugar level (hyperglycaemia) if you have diabetes
• swollen ankles
• indigestion
• risk of infection, for example a UTI or thrush

Please contact your GP, pharmacist or MS team if your side effects continue, or you are worried about them.

Indigestion

Contact your MS team or GP for advice If you have indigestion while taking methylprednisolone. They might give you medicine which can help to protect your stomach lining. You will only need to take this medicine while you are taking steroids.

You might also be given medicine to protect your stomach lining if you:

• take regular anti-inflammatory medicines, such as aspirin or ibuprofen
• have a history of stomach ulcers
• take blood thinning medicine, such as warfarin

Long-term effects of steroids

If you take lots of steroids over a long period of time, it can cause thinning of your bones (osteoporosis). You should not have more than 2 or 3 courses of steroids a year. If your doctor thinks you are at risk of osteoporosis, you might need to have a bone scan, or take vitamin D or calcium supplements.