MS - Symptoms

Multiple sclerosis symptoms generally appear between the ages of 20 and 40. The onset of MS may be dramatic or so mild that a person doesn't even notice any symptoms until far later in the course of the disease.

The most common early symptoms of MS include:

  • Tingling
  • Numbness
  • Loss of balance
  • Weakness in one or more limbs
  • Blurred or double vision

Less common symptoms of MS may include

  • Slurred speech
  • Sudden onset of paralysis
  • Lack of coordination
  • Cognitive difficulties

As the disease progresses, other symptoms may include muscle spasms, sensitivity to heat, fatigue, changes in thinking or perception, and sexual disturbances.

  • Fatigue: This is the most common symptom of MS. It is typically present in the mid afternoon and may consist of increased muscle weakness, mental fatigue, sleepiness, or drowsiness.
  • Heat sensitivity: Heat sensitivity (the appearance or worsening of symptoms when exposed to heat, like a hot shower) occurs in most people with MS.
  • Spasticity: Muscle spasms are a common and often debilitating symptom of MS. Spasticity usually affects the muscles of the legs and arms, and may interfere with a persons ability to move those muscles freely.
  • Dizziness: Many people with MS complain of feeling "off balance" or lightheaded. Occasionally they may experience the feeling that they or their surroundings are spinning; this is called vertigo. These symptoms are caused by damage in the complex nerve pathways that coordinate vision and other inputs into the brain that are needed to maintain balance.
  • Impaired thinking: Problems with thinking occur in about half of people with MS. For most, this means slowed thinking, decreased concentration, or decreased memory. Approximately 10% of people with the disease have severe impairment that significantly impairs their ability to carry out tasks of daily living.
  • Vision problems: Vision problems are relatively common in people with MS. In fact, one vision problem, optic neuritis, occurs in 55% of people with the condition. Most vision problems do not lead to blindness.
  • Abnormal sensations. Many people with MS experience abnormal sensations such as "pins and needles," numbness, itching, burning, stabbing, or tearing pains. Fortunately, most of these symptoms, while aggravating, are not life-threatening or debilitating and can be managed or treated.
  • Speech and swallowing problems: People with MS often have swallowing difficulties. In many cases, they are associated with speech problems as well. They are caused by damaged nerves that normally aid in performing these tasks.
  • Tremors: Fairly common in people with MS, tremors can be debilitating and difficult to treat.
  • Difficulty walking. Gait disturbances are amongst the most common symptoms of MS. Mostly this problem is related to muscle weakness and/or spasticity, but having balance problems or numbness in your feet can also make walking difficult.
Other rare symptoms include breathing problems and seizures.

What Are the Types of Symptoms?

It is helpful to divide the symptoms into three categories: primary, secondary, and tertiary.

Primary symptoms are a direct result of the demyelination process. This impairs the transmission of electrical signals to muscles (to allow them to move appropriately) and the organs of the body (allowing them to perform normal functions.) The symptoms include: weakness, tremors, tingling, numbness, loss of balance, vision impairment, paralysis, and bladder or bowel problems. Medication, rehabilitation, and other treatments can help keep many of these symptoms under control.

Secondary symptoms result from primary symptoms. For example, paralysis (a primary symptom) can lead to bedsores (pressure sores) and bladder or urinary incontinence problems can cause frequent, recurring urinary tract infections. These symptoms can be treated, but the ideal goal is to avoid them by treating the primary symptoms.

Tertiary symptoms are the social, psychological, and vocational complications associated with the primary and secondary symptoms. Depression, for example, is a common problem among people with MS.

What Causes the Symptoms?

Demyelination, or deterioration of the protective sheath that surrounds nerve fibers, can occur in any part of the brain or spinal cord. The symptoms that people with MS experience depend on the affected area. Demyelination in the nerves that send messages to the muscles causes problems with movement (motor symptoms), while demyelination along the nerves that carry sensory messages to the brain causes disturbances in sensation.

Are Symptoms the Same in Every Person?

Multiple sclerosis follows a varied and unpredictable course. In many people, the disease starts with a single symptom, followed by months or even years without any progression of symptoms. In others, the symptoms become worse within weeks or months.

It is important to understand that although a wide range of symptoms can occur, a given individual may experience only some of the symptoms and never have others. Some symptoms may occur once, resolve, and never return. Because MS is such an individual disease, it is not helpful to compare yourself with other people who have MS.