{"id":"https://openalex.org/W7214726243","doi":"https://doi.org/10.7759/cureus.117167","title":"Pseudo-Exacerbation in Primary Progressive Multiple Sclerosis: A Case Report","display_name":"Pseudo-Exacerbation in Primary Progressive Multiple Sclerosis: A Case Report","publication_year":2026,"publication_date":"2026-09-29","ids":{"openalex":"https://openalex.org/W7214726243","doi":"https://doi.org/10.7759/cureus.117167","pmid":"https://pubmed.ncbi.nlm.nih.gov/42960373","pmcid":"https://www.ncbi.nlm.nih.gov/pmc/articles/13719142"},"language":"en","primary_location":{"id":"doi:10.7759/cureus.117167","doi":"https://doi.org/10.7759/cureus.117167","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117167","pdf_url":"https://www.cureus.com/articles/491528-pseudo-exacerbation-in-primary-progressive-multiple-sclerosis-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://www.cureus.com/articles/491528-pseudo-exacerbation-in-primary-progressive-multiple-sclerosis-a-case-report.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5148549614","display_name":"Parisa Moshfeqa","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2802809408","display_name":"Glangwili General Hospital","ror":"https://ror.org/01cs14q41","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2802809408","https://openalex.org/I4210100445","https://openalex.org/I4210144625"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Parisa Moshfeqa","raw_affiliation_strings":["Internal Medicine, Glangwili General Hospital, Carmarthen, GBR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Internal Medicine, Glangwili General Hospital, Carmarthen, GBR","institution_ids":["https://openalex.org/I2802809408"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5093820994","display_name":"Norhan Shaykhon","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800238109","display_name":"Withybush General Hospital","ror":"https://ror.org/03k51eb57","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800238109","https://openalex.org/I4210100445","https://openalex.org/I4210144625"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Norhan Shaykhon","raw_affiliation_strings":["Psychiatry, Withybush General Hospital, Pembrokeshire, GBR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Psychiatry, Withybush General Hospital, Pembrokeshire, GBR","institution_ids":["https://openalex.org/I2800238109"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5148493838","display_name":"Sooraj Viswanathan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800238109","display_name":"Withybush General Hospital","ror":"https://ror.org/03k51eb57","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800238109","https://openalex.org/I4210100445","https://openalex.org/I4210144625"]}],"countries":["GB"],"is_corresponding":true,"raw_author_name":"Sooraj Viswanathan","raw_affiliation_strings":["Internal Medicine, Withybush General Hospital, Pembrokeshire, GBR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Internal Medicine, Withybush General Hospital, Pembrokeshire, GBR","institution_ids":["https://openalex.org/I2800238109"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5153510204","display_name":"Gavin Ross","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2800238109","display_name":"Withybush General Hospital","ror":"https://ror.org/03k51eb57","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2800238109","https://openalex.org/I4210100445","https://openalex.org/I4210144625"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Gavin Ross","raw_affiliation_strings":["Gastroenterology, Withybush General Hospital, Pembrokeshire, GBR"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Gastroenterology, Withybush General Hospital, Pembrokeshire, GBR","institution_ids":["https://openalex.org/I2800238109"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5148493838"],"corresponding_institution_ids":["https://openalex.org/I2800238109"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.70540777,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"18","issue":"9","first_page":"e117167","last_page":"e117167"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10137","display_name":"Multiple Sclerosis Research Studies","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10137","display_name":"Multiple Sclerosis Research Studies","score":0.9994999766349792,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11735","display_name":"Peripheral Neuropathies and Disorders","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/2728","display_name":"Clinical Neurology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11381","display_name":"Infectious Diseases and Tuberculosis","score":0.0,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/primary-progressive-multiple-sclerosis","display_name":"primary progressive multiple sclerosis","score":0.9990000128746033},{"id":"https://openalex.org/keywords/pharyngitis","display_name":"pharyngitis","score":0.8270000219345093},{"id":"https://openalex.org/keywords/systemic-infection","display_name":"systemic infection","score":0.781000018119812},{"id":"https://openalex.org/keywords/lower-limb-weakness","display_name":"lower limb weakness","score":0.6779999732971191},{"id":"https://openalex.org/keywords/corticosteroid-avoidance","display_name":"corticosteroid avoidance","score":0.8659999966621399},{"id":"https://openalex.org/keywords/inflammatory-markers","display_name":"inflammatory markers","score":0.3540000021457672}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.97079998254776},{"id":"https://openalex.org/C2777977315","wikidata":"https://www.wikidata.org/wiki/Q7243056","display_name":"Primary (astronomy)","level":2,"score":0.4068000018596649},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.29440000653266907},{"id":"https://openalex.org/C2984752397","wikidata":"https://www.wikidata.org/wiki/Q3259956","display_name":"Primary care","level":2,"score":0.2897000014781952},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.2824000120162964},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.27639999985694885},{"id":"https://openalex.org/C2778822529","wikidata":"https://www.wikidata.org/wiki/Q1951525","display_name":"Progressive disease","level":3,"score":0.24240000545978546},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.23810000717639923},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.22849999368190765},{"id":"https://openalex.org/C2777601897","wikidata":"https://www.wikidata.org/wiki/Q3409113","display_name":"Presentation (obstetrics)","level":2,"score":0.20999999344348907}],"mesh":[],"locations_count":3,"locations":[{"id":"doi:10.7759/cureus.117167","doi":"https://doi.org/10.7759/cureus.117167","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117167","pdf_url":"https://www.cureus.com/articles/491528-pseudo-exacerbation-in-primary-progressive-multiple-sclerosis-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13719142","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13719142/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13719142/pdf/cureus-0018-00000117167.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Text"},{"id":"pmid:42960373","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42960373","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"Case Reports"}],"best_oa_location":{"id":"doi:10.7759/cureus.117167","doi":"https://doi.org/10.7759/cureus.117167","is_oa":true,"landing_page_url":"https://doi.org/10.7759/cureus.117167","pdf_url":"https://www.cureus.com/articles/491528-pseudo-exacerbation-in-primary-progressive-multiple-sclerosis-a-case-report.pdf","source":{"id":"https://openalex.org/S2738950867","display_name":"Cureus","issn_l":"2168-8184","issn":["2168-8184"],"is_oa":true,"is_in_doaj":false,"is_core":true,"listed_in":["cwts-core","poland-20","russia-white-list-2","vabb-shw"],"host_organization":"https://openalex.org/P4310316779","host_organization_name":"Cureus, Inc.","host_organization_lineage":["https://openalex.org/P4310316779"],"host_organization_lineage_names":["Cureus, Inc."],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Cureus","raw_type":"journal-article"},"sustainable_development_goals":[{"score":0.9922999739646912,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"}],"study_designs":[{"display_name":"Case Report","id":"https://openalex.org/study-designs/case-report"}],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7214726243.pdf","grobid_xml":"https://content.openalex.org/works/W7214726243.grobid-xml"},"referenced_works_count":13,"referenced_works":["https://openalex.org/W2002265763","https://openalex.org/W2004742608","https://openalex.org/W2018795781","https://openalex.org/W2026746320","https://openalex.org/W2112165124","https://openalex.org/W2130801305","https://openalex.org/W2145593481","https://openalex.org/W2189829250","https://openalex.org/W2299352023","https://openalex.org/W2964412348","https://openalex.org/W4200192876","https://openalex.org/W4206631994","https://openalex.org/W7154603763"],"related_works":["https://openalex.org/W7154603763","https://openalex.org/W2166157709","https://openalex.org/W4253654643","https://openalex.org/W6980931899","https://openalex.org/W4388154218","https://openalex.org/W97007528","https://openalex.org/W3014568731","https://openalex.org/W2287734800","https://openalex.org/W2531000114","https://openalex.org/W4390139704"],"abstract_inverted_index":{"Primary":[0],"progressive":[1],"multiple":[2],"sclerosis":[3],"(PPMS)":[4],"is":[5],"characterised":[6],"by":[7],"gradual":[8],"neurological":[9,18,76,101,170,190],"deterioration":[10],"from":[11,92,180],"disease":[12,42],"onset":[13],"without":[14,129],"distinct":[15],"relapses.":[16],"Acute":[17],"worsening":[19],"in":[20,32,183],"patients":[21,184],"with":[22,57,62,104,123,136,167,185,188],"PPMS":[23,59,186],"can":[24,201],"present":[25],"a":[26,45,54,73,105,113],"diagnostic":[27],"challenge,":[28],"particularly":[29],"when":[30],"occurring":[31],"the":[33,51,96,109,150,160,175,212],"context":[34],"of":[35,53,98,177,197,211],"systemic":[36,199],"infection,":[37],"where":[38],"pseudo-relapse":[39,91,114,179],"may":[40],"mimic":[41],"progression":[43],"or":[44],"true":[46,93,181],"inflammatory":[47,83],"relapse.":[48,94],"We":[49],"report":[50],"case":[52,173],"65-year-old":[55],"woman":[56],"established":[58],"who":[60],"presented":[61],"fever,":[63],"sore":[64],"throat,":[65],"and":[66,78,103,126,141,152,195],"acute":[67,189],"bilateral":[68],"lower-limb":[69],"weakness.":[70],"Assessment":[71],"included":[72],"detailed":[74],"history,":[75],"examination,":[77],"laboratory":[79],"investigations":[80],"demonstrating":[81],"increased":[82],"markers.":[84],"Neurology":[85],"review":[86],"was":[87,111,121,134,148],"undertaken":[88],"to":[89,116,138],"distinguish":[90],"In":[95],"absence":[97],"new":[99,169],"focal":[100],"deficits":[102],"probable":[106],"infective":[107],"trigger,":[108],"episode":[110],"considered":[112],"secondary":[115],"presumed":[117],"pharyngitis.":[118],"The":[119],"patient":[120],"treated":[122],"empirical":[124],"antibiotics":[125],"supportive":[127],"rehabilitation":[128],"corticosteroids.":[130],"Significant":[131],"clinical":[132,157,193],"improvement":[133],"observed,":[135],"return":[137],"baseline":[139],"mobility":[140],"functional":[142],"status.":[143],"As":[144],"no":[145,168],"contemporaneous":[146],"MRI":[147],"performed,":[149],"diagnosis":[151],"treatment":[153],"were":[154],"based":[155],"on":[156],"grounds.":[158],"At":[159],"two-month":[161],"follow-up,":[162],"she":[163],"remained":[164],"clinically":[165],"stable":[166],"deficits.":[171],"This":[172],"highlights":[174],"importance":[176],"distinguishing":[178],"relapse":[182],"presenting":[187],"deterioration.":[191],"Careful":[192],"assessment":[194],"recognition":[196],"reversible":[198],"triggers":[200],"help":[202],"avoid":[203],"unnecessary":[204],"corticosteroid":[205],"exposure":[206],"while":[207],"ensuring":[208],"appropriate":[209],"management":[210],"underlying":[213],"cause.":[214]},"counts_by_year":[],"updated_date":"2026-11-08T12:12:28.789561","created_date":"2026-09-30T00:00:00"}