Which of the following is an exercise red flag for multiple sclerosis?

• A. Severe daytime sleepiness with rest.
• B. Mild fatigue.
• C. Normal vision.
• D. Sudden neurological deterioration.

Answer: (D)

During exercise in multiple sclerosis, an abrupt change in neurological function is the red flag. Sudden deterioration, such as new weakness, numbness, trouble speaking or seeing, or sudden loss of coordination, signals an acute relapse or another urgent issue and requires stopping activity and seeking medical evaluation right away. MS symptoms can fluctuate with fatigue, heat, or time of day, but these are not emergencies. Mild fatigue or normal vision are common and don’t by themselves indicate an urgent problem, whereas a sudden change in neurological status does.