Multiple sclerosis (MS) is disease of the central nervous system and its symptoms will vary according to which part of the body is affected and to what degree. There is no typical case of MS and symptoms will present in different ways.
Symptoms of multiple sclerosis are varied and unpredictable, and no two people will experience the same symptoms to the same degree. Symptoms can come and go, and can also be affected temporarily by other factors such as hot weather or if you have an infection. Although MS can cause a wide variety of symptoms, most people only experience a small number of these. And for most of the common MS symptoms there are now many effective forms of symptom management. It is also important to note that the symptoms listed here are not exclusive to MS and can appear in many different neurological conditions. Having any of these symptoms does not mean you have MS.
Fatigue is one of the most common (and most troubling) symptoms of MS. Fatigue due to MS can be a debilitating kind of general exhaustion and weariness which is unpredictable or disproportionate to the activity.
Visual symptoms include blurring of vision, double vision (diplopia), inflammation of the optic nerve (optic neuritis), pain, reduction in colour vision, involuntary rapid eye movement, and (rarely) total loss of sight.
Balance and coordination problems
These include loss of balance, tremors, unstable walking (ataxia), dizziness (vertigo), clumsiness of a limb, lack of coordination, and weakness (affecting in particular the legs).
Spasticity [or] Muscle stiffness and spasms
Altered muscle tone, muscle spasms and muscle stiffness (spasticity) can affect mobility and walking.
Altered sensation includes tingling, ‘pins and needles’, numbness (paraesthesia) and burning sensations.
This includes muscle pains, facial pain (such as trigeminal neuralgia), sharp stabbing pains and burning tingling pain.
This includes slowing of speech, slurring of words, changes to speech rhythm and difficulty swallowing (dysphagia).
Bladder problems include the need to empty the bladder more frequently and/or urgently than usual, incomplete emptying, the need to urinate frequently overnight (nocturia) and accidental or involuntary release of urine from the bladder (incontinence). Bowel problems include constipation and less commonly, loss of bowel control.
Changes to sexuality and intimacy
This includes diminished arousal, loss of sensation, and impotence.
Increased sensitivity to heat is a common symptom of MS and can often worsen other symptoms such as pain, fatigue and cognitive issues.
This includes problems with thinking or cognition such as short-term memory loss, concentration problems, difficulty planning or problem solving and impaired judgement or decision-making ability. These symptoms are often described by people with MS as “fuzziness” or “brain fog”.
The most commonly diagnosed form of MS is relapsing-remitting MS, characterised by unpredictable flare ups, bouts or episodes known as ‘relapses’. Relapses are unpredictable and can be difficult to diagnose, particularly when other MS and non-MS-related health issues are being experienced.
A relapse can be defined as the development of new symptoms, or the temporary worsening or recurrence of old symptoms not caused by an infection or other illness. It must last for more than 24 hours and also occur at least 30 days after any previous episode. A relapse has the potential to occur gradually over a few days or weeks.
It can be difficult to know if you are experiencing a relapse due to the variability of MS symptoms at any given time. Any changes to symptoms should be referred to your neurologist who can diagnose a relapse and assist you with relapse management.
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