This is a new page on Dr. David Wheldon's site, discussing relapses and pseudo relapses in antibiotic treatment, following on from this section:
Can relapses occur after starting antibiotics?
In relapsing-remitting MS the major cause of relapse, a new respiratory infection with Chlamydia pneumoniae, will be prevented by the antibiotics. However, for the first six months or so it is possible for a relapse to occur secondary to a virus infection. This may be particularly likely in a household with young children.
Not all new deficits which occur during treatment are relapses, though:
Relapses and Pseudo-relapses
The relapse in early relapsing-remitting MS has a typical pathology irrespective of its location. The first visible event is the orderly, local, mass death of oligodendrocyctes, the cells which support myelin. The myelin associated with these cells then degenerates. Degenerating myelin activates an inflammatory process. When this is over, young oligodendrocytes mature and make new myelin. The clinical counterpart to this pathology (unless it occurs in a silent area) is a loss of function which worsens over several hours to two days. The loss of function remains in place until the inflammation is over and remyelination begins. It will thus be seen that the relapse has a definite pattern and timescale.
Some people experience strange new sensations on beginning antibiotics and are often afraid that these are relapses. While relapses can occur during the first few months of antibiotics, probably initiated by virus infections, these sensations do not fulfil the timescale criteria of true relapses and tend to change their form within a week. Sometimes, in fact, they herald a return of function. What causes these 'pseudo-relapses' I do not know, but I suspect it is rebudding of neurones which make trial-and-error connections. Synaesthesia (crossover of the senses) can sometimes result; as an example, the seeing of flashes of light when hearing a loud noise. They can be quite troubling even when improvement is taking place. Repair takes place at a cellular level; function has to be re-learned at a much higher level.