@DVGFleming 

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DVGFleming

Relapse?

Apologies asking this on here as I have a very poor relationship with neurologist which has led me to not communicate with ms team (my choice). Hot itchy strip (some liken it to spiders crawling) on left thigh, started 9th December disappeared 4 weeks ago. Muscle twitching in right quad, above knee, had for a week, about fortnight ago. Would this be classed as a relapse? I know definition of relapse and already looking like I have ppms, or so I've been told(ish). You looking for opinions on this. Thanks in advance.
@mellowmedusa

Hey - my opinion: if you know the definitions, then you know that the first symptom described could be quantified as a single sensory episode of possible relapse activity. But you won't get clinical confirmation of that unless it's matched nearly immediately with a new MRI lesion as it doesn't meet criteria to be a) clinical significant (motor/brainstem/functional/intrusive pain/spincter/ON) or b) disabling (stops you from working or living your daily life). Sensory episodes are also subjective (i.e. a neuro exam can't confirm them). The second would not qualify as a) not divided from first by 30 days of no activity and b)fasciculations are difficult to quantify - they're common in MS, but also in other conditions. Also in MS may not always be due to demyelinated nerve fibres, sometimes its de-conditioned muscle, etc. However, your neurologist might say different. These things seem to be a lot less clear-cut than you would think.

@DVGFleming

Thanks @mellowmedusa . I'm learning nothing is clearcut with MS. Very good explanation though