In NMO, the nervous system is damaged, and may never heal the way that it was prior to a relapse. The lesion that is present could always "act up" if there is a disturbance in your body. This is called a pseudo relapse. These pseudo relapses feel like a real relapse, however they:
• Are always in a part of the body that was previously affected at one time by your NMO.
• The symptoms are always similar to a previous attack.
These are temporary changes in symptoms, which look like and act like real relapses, but are temporary and do not indicate disease activity or progression. Realize that when we talk about psueudo relapses we are certainly speaking of very real symptoms as there’s nothing “fake” about the experience; it is just temporary. Common triggers that may cause a psueudo relapses include infection, especially urinary tract infection, stress, pain or fatigue, exposure to heat or cold, premenstrual syndrome, and even changes in medications.
The good news about pseudorelapses is that once the metabolic disturbance is corrected, the symptoms return to baseline. There is no permanent damage left by a pseudorelapse.
However, you also need to be aware that it COULD be a new flare. If the symptoms you are experiencing are a new problem, this is concerning for an NMO relapse. Common examples of new symptoms associated with a relapse are:
• Sudden vision loss, pain in the eye, pain with eye movement.
• Hiccups, Nausea and Vomiting, Excessive Sleeping.
•Weakness in the arms or legs
•Sensory loss in the arms or legs
• Change in bowel or bladder function
• New pain in the arms, legs or trunk
If your symptoms are flaring, but you have had the symptoms before with a previous relapse, the chance of new relapse is lower but still possible. For example, if your right leg was weak last year during a relapse and is now weaker again in the same way, this may be due to something else.
That is why we need to be vigilant about NMO symptoms, especially if they are new and worsening!