Multiple sclerosis

Multiple sclerosis relapse is more commonly found to occur in all of the following

situations EXCEPT which one?

a) Post-partum

b) Following influenza immunisation

c) In the spring and summer

d) Following periods of stress

e) Following hyperpyrexia

Answer: b

Explanation

Multiple sclerosis is an autoimmune disease characterised by demyelination of the central

nervous system. Progression of the disease takes many forms but typically will involve

either new symptoms occurring following acute attacks (relapsing) or slowly occurring

over time (progressive).Anumber of factors have been shown to have associationswith or

to cause relapses. Pregnancy is protective against relapses in the third trimester, but once

delivery has occurred is associated with relapse. There is no evidence showing an association

between influenza immunisation andmultiple sclerosis relapse. Relapse does have a

seasonal variation and is associated with stress and raised temperature.

Reference

Confavreux C, Suissa S, Saddier P, Bourdès V, Vukusic S. Vaccinations and the risk of

relapse in multiple sclerosis. Vaccines in Multiple Sclerosis Study Group. New Engl J

Med 2001; 344(5): 319–26.