My wife is having a severe relapse

Question

Hi all. Relatively new to the MS community here. My wife is DX with RRMS about a year ago, even though SHE had symptoms for a few years before (hindsight is great). We are also pregnant with our first child. However, my wife has just had a sudden and  severe relapse. Her balance is awful, weakness in legs so effectively unable to walk, extremely slurred speech and very difficult to understand. She is also having uncontrollable bouts of laughter?  I mean, she goes into hysterics for no reason!

She was admitted to hospital last night, and relucatantly given a dose of IV steroids and will continue on these for 5 x days. 

JUst wondering, has anyone here ever had a relapse like this? I think it's the poor speech that is getting her down. We can't even talk to one another, as I can't understand here, and she is so embarassed ( I have told her not to be).  We can deal with the balance issues (sort of) but it just makes this so much harder when we can't even talk to one another. Has anyone experieced this before? Do you think that we can expect her speech to come back when the nerve inflammation settles down?

Lulu54 · Answer

that is good news- thanks for checking back in with the update.  Now the challenge is to use foresight - enjoy preparing for that new baby and also thinking of the next MS treatments she might use after delivery.  I hope it all goes well and you know where we are if you have more quesitons.  

My best to you both, L

bannerdb · Answer

More good news. Strength coming back into legs now as well as arm. Speech nearly back fully now. Thanks all for the jind words and advice

Lulu54 · Answer

that's good news - steroids can do some pretty amazing things in snapping a relapse. I hope she can continue the improvement - rest is a good thing for both of you. I've been reading what eveyrone else has offered and I hope you will continue to give us updtes.

bannerdb · Answer

Hi Alex. Thanks for your reply also. Did your speech always return to normal? I'm just back from visiting my wife. Good news! There has been a small but definite improvement in her speech. We sat and talked for 2 hours and I didn't have to ask her to repeat herself once! It's still quite slurred and quiet but at least she can communicate with us now. Some strength coming back to the legs also.

bannerdb · Answer

No they haven't done any brain imaging due to her pregnancy. All we are hoping for is that her speech returns. She can't write either as her hands are wobbly.

Quixotic1 · Answer

I meant to say also that the difficulty with speech is from a problem with one of the cranial nerves dealing with the muscles of speech along with, I believe, the cerebellum.

Have they done any imaging of the brain looking for increased intracranial pressure?

Q

Quixotic1 · Answer

I would suggest that she remain under the care of the perinatologist while she is getting the steroids and while she is having neuro symptoms.  What your are describing could definitely be a relapse of MS, and yes it IS possible for the symptoms to occur during pregnancy.  We have had such reports here before.

The difficulty talking is a classic MS problem as is the inappropriate laughter.  And it IS called the Pseudobulbar Affect as suggested above.  This is another thing that is seen in several neurological conditions of which MS is the one that always comes to mind first.  One of our oldest members of the forum was diagnosed this way when she went to the ER with difficulty walking.  In the ER they were watching her try to walk and she was laughing hysterically.  The ER doc took the husband aside and told him he wanted to rule out MS -> Dx.

In the meantime, can she write to you to talk?

I'm not weighing in on whether this is MS or a pregnancy-related problem, just that everything you mentioned is consistent with an MS relapse even though it is during the pregnancy.

My thoughts are with you two and please keep us posted.

Quix, MD

HVAC · Answer

I have had trouble talking it is scarey. I have never been pregnant. Anything which takes a lot of energy can set off MS. What every  one is saying about not everything being MS when you get sick is true. Doctors sometimes blame things on MS that are not. But it could be that is what makes it so weird.

Alex

babybear2200 · Answer

Hello and welcome. I am also recently diagnosed and as such I don't really have a lot of useful information for you. However, I had full blown eclampsia with my daughter that was not caught at the early stages due to my blood pressure normally being on the low end. I typically run around 100-110 over 50-60. When my bp went up to 125/94 I made the comment that it was pretty high for me but it was disregarded until the seizures and other symptoms started. If your wife typically has low bp and she is running closer to normal let them know and be prepared to fight the point for her.  

Also, have they checked her magnesium and all b vitamin levels? If not, ask them to. Baby is taking quite a bit of what she needs and those vitamins being low can reek quite a bit of havoc on us but if caught can have a pretty simple solution. 

I hope this helps and your wife feels better soon! You sound like a wonderfully supportive husband and I wish you and your family nothing but the best! I'll keep you, your wife and little one in my thoughts and prayers for a speedy recovery. 

Hugs

immisceo · Answer

Regarding the uncontrollable laughter, perhaps she's having this: https://en.wikipedia.org/wiki/Pseudobulbar_affect

I'm so sorry this is happening to you both.

bannerdb · Answer

No, apart from the diziness that was causing the balance problems. It seems to have eased a bit. But, her speech is still very poor, and she still has quite a lot of weakness in the legs. :-( My heart is breaking for her.

PeninaD · Answer

It can happen at any time, but most common towards the end.
 Is she feeling any better???

bannerdb · Answer

Indeed, this is what we thought. We were expecting her to get a bit of a break when she was pregnant. We never expected a horrible attack like this. We are just hoping that things settle down again when the steroids kick in. 

Also, I should point out, she is only just 4 months pregnant. Would pre eclampsia be an issue this early on in pregnancy?

PeninaD · Answer

It sound like they thought of pre-eclampsia, so they probably did, but just make sure, and see if they will recheck along the way.

Of course it is entirely possible that this is her MS, but MS is not usually immediately life threatening in the same way that pregnancy complications can be.  And often, MS goes into remission during pregnancy, only to flare shortly after childbirth.

PeninaD · Answer

Not at first.  Did they check her urine for protein?

bannerdb · Answer

I don't think that this was even mrntioned, except that the first thing they did was to take her to the anti-natal ward and check the baby, and did blood tests and took blood pressure etc. If it was pre-eclampsia, surely her BP would be affected?

PeninaD · Answer

They are absolutely sure that this is not a pregnancy related complication, such as pre-eclampsia? (which can cause loss of control and mental status changes)