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Updated: Apr 14, 2026

A Method of Trigonometric Modelling of Seasonal Variation Demonstrated with Multiple Sclerosis Relapse Data
Published on: December 9, 2015
Rebound exacerbation multiple sclerosis following cessation of oral treatment
Roy G Beran1, Yaser Hegazi2, Raymond S Schwartz3
1Department of Neurology, Liverpool Hospital and The South Western Sydney Clinical School, University of New South Wales, New South Wales (NSW), Australia; School of Medicine, Griffith University, Queensland, Australia; Strategic Health Evaluators, PO Box 598, Northbridge, 1560 NSW, Australia.
Background:
Multiple sclerosis (MS) management is changing, revolutionized by oral agents. Immune Reconstitution Inflammatory Syndrome (IRIS) describes exaggerated response to both exogenous (infective) and endogenous (non-infective) antigens.
Methods:
This paper reports two cases of MS "rebound" following withdrawal of oral treatments.
Results:
Two patients, with suboptimal response to interferons, trialled oral MS treatment (fingolimod and BG12) with excellent response. Upon cessation both experienced MS "rebound" which responded to steroids.
Conclusions:
"Rebound" may occur following withdrawal of oral MS therapies. Patients should be advised accordingly and possibly started on alternative treatment before the immunomodulating effect of therapy has subsided.
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