Unexplained Fevers as a Surprising Symptom of Multiple Sclerosis

Understanding Unexplained Fever as a Symptom of Multiple Sclerosis

Multiple sclerosis (MS) is an autoimmune disease that affects the central nervous system. It damages the myelin sheath that protects nerve fibers, causing communication problems between the brain and body. MS is a complex condition with a variety of possible symptoms. While some symptoms are well-known hallmarks of the disease, others are less commonly associated with MS.

One of the more surprising symptoms that can occur with MS is unexplained fever. About 1 in 10 people with MS experience this symptom. Fevers occur when the hypothalamus, the body's temperature control center, resets the thermostat to initiate a fever. When this happens independent of any infection or other cause, it is called an unexplained or idiopathic fever.

Understanding Fevers in MS

Fevers are commonly caused by infections as the body works to eliminate invaders. But people with MS can experience fevers without any infection present. These MS-related fevers are thought to be caused by the overactive immune system associated with the disease.

The MS immune system attacks the myelin coating around nerves, leading to damage and disruption of nerve signals. Experts think the misguided immune cells may also attack other healthy tissues, triggering widespread inflammation and resets of the hypothalamic thermostat to elevate body temperature.

MS fevers are often low-grade, around 100F, but can sometimes spike higher. Fevers may come and go unpredictably or last for longer periods. They can happen during MS relapses or even when the disease is stable. MS fevers frequently occur along with worsening of other MS symptoms.

Impact of Fevers on MS Symptoms

Fevers seem to aggravate MS symptoms, even if there is no relapse or new damage occurring. The increased body temperature may impair nerve conduction and functioning. Some common effects of fevers include:

• More severe fatigue and weakness
• Problems with vision, balance, walking, coordination
• Increased numbness, tingling, burning sensations
• More severe bladder and bowel symptoms
• Mental fuzziness, confusion
• General worsening of existing MS symptoms

These worsening MS symptoms often resolve when the fever goes away. However, a prolonged fever may provoke a true flare up with new myelin damage and lasting symptom progression.

Treating MS-Related Fevers

Since MS fevers are not caused by infection, antibiotics are ineffective. Typical over-the-counter fever reducers like acetaminophen or ibuprofen can help lower an elevated temperature. Cooling techniques like cold compresses, ice packs, and cool baths may also provide relief.

Corticosteroids by pill or IV are the most common medication treatment for MS fevers and flare ups. These powerful anti-inflammatories calm the overactive immune system and reset the hypothalamic thermostat.

Identifying and avoiding triggers is also recommended. Stress, overheating from hot weather or baths, and some medications are known fever triggers. Staying well hydrated, keeping cool, and dressing in light layers can help prevent heat-induced fevers.

Treating the fever and minimizing its impact on MS symptoms provides relief in the short term. To reduce future fevers and progression, disease modifying therapies that alter the immune system may be beneficial.

Other Surprising MS Symptoms

Along with unexplained fevers, there are various other unusual symptoms that can manifest with MS. Being aware of the range of potential symptoms is important for early and accurate diagnosis.

Vision Problems

Optic neuritis, or inflammation of the optic nerve, is a common MS-related eye symptom. This can cause eye pain, vision loss, blurry vision, or blind spots. But MS can also provoke other eye symptoms not directly related to optic neuritis:

• Diplopia - Double vision caused by miscommunication between the eyes and brain.
• Nystagmus - Involuntary eye movements back and forth or up and down.
• Oscillopsia - The sensation that surroundings are moving or jumping around when they are still.

Seizures

Around 3-5% of people with MS experience seizures, ranging from mild to severe. This occurs when MS lesions form in seizure-prone areas of the brain, leading to abnormal electrical activity. Anti-seizure medications can help control MS-related seizures.

Breathing Problems

Shortness of breath and other breathing issues can occur when MS damages the brainstem regions that coordinate respiration. Sucking in the stomach muscles with breathing is a red flag for MS. Steroids provide quick relief, while specific breathing therapies and exercises can retrain proper breathing patterns.

Swallowing Difficulties

Dysphagia, or impaired ability to swallow, affects up to a third of MS patients at some point. This happens when MS lesions form in the brain areas controlling swallowing. Eating softened foods, learning swallowing techniques, and sometimes tube feeding can help manage dysphagia.

Speech Problems

Slurred speech, slowed speaking rate, and changes in voice quality can happen with MS. Lesions in language centers of the brain disrupt communication between speech-related areas. Speech therapy helps retrain coordination between breathing, voice, articulation, and resonance.

Cognitive Changes

Up to 70% of people with MS experience some degree of altered cognitive function. Common issues include impaired processing speed, short-term memory, concentration, word finding, planning, and decision making. Cognitive symptoms are managed through medications, behavioral modifications, cognitive rehabilitation therapy, and coping strategies.

Mood Changes

Rates of depression, anxiety, bipolar disorder, and other psychiatric conditions are high among the MS population. Irritability, emotional volatility, uncontrolled laughter or crying are also common. A combination of therapy, psychiatric medications, stress reduction, exercise, and support groups can help stabilize mood disorders.

Nerve Pain

Neuralgia, pins-and-needles feelings, burning, and painful spasms are common in MS as damaged nerves misfire and become oversensitive. Anti-seizure drugs, tricyclic antidepressants, lidocaine patches, massage, and relaxation techniques are used to manage nerve pain.

When to See a Doctor

Unexplained fevers or any other mysterious neurological symptoms are reason to see a doctor promptly. Early diagnosis and treatment of MS leads to better outcomes and delays progression of disability. If you experience any of the following, seek medical evaluation:

• Fevers over 100F without infection
• Fatigue, numbness, vision changes, dizziness, weakness
• Clumsiness, impaired balance, coordination
• Slurred speech, swallowing difficulties
• Memory loss, confusion, mood swings
• Bladder problems, constipation, sexual dysfunction
• Numbness, tingling, burning, electric shock sensations
• Pain, spasms, tightness, stiffness

A doctor will review symptoms, perform a neurological exam, and order tests like MRI scans to aid in diagnosis. Often they will test for and rule out other possible causes besides MS. Early intervention improves outcomes and prevents escalation of the disease over time.

Living with MS Fever Symptoms

Experiencing unexplained fevers along with other MS symptoms can be frustrating and concerning. While fevers cannot always be prevented, some strategies can help reduce their frequency and impact on daily life:

• Take fever reducers as soon as temperature rises.
• Apply cooling techniques like ice packs, cool rags, cool baths.
• Drink plenty of fluids and avoid dehydration.
• Reduce exposure to heat through air conditioning, shade, avoiding hot baths.
• Use relaxation techniques like meditation and deep breathing.
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Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.