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Multiple sclerosis

Symptoms

There are a wide range of symptoms of multiple sclerosis (MS), which can vary greatly from person to person.

Your central nervous system (your brain and spinal cord) controls all your body's actions, so when MS causes damage to the nerve fibers which carry messages from your brain, symptoms can occur in any part of your body.

However, most people with MS only have a few of these symptoms, and it is very unlikely that someone would develop all of the possible symptoms.

Some of the most common possible symptoms of MS are outlined below.

Visual problems

In 25% of cases of MS, the first symptom is inflammation (swelling) of the optic nerve, known as optic neuritis. This usually only affects one eye, and causes pain behind your eyeball and some loss of vision.

You may also experience double vision, pain in both eyes, some color blindness, and difficulty focusing (known as nystagmus).

Muscle spasms and spasicity

MS causes damage to the nerve fibers in your central nervous system, which can cause your muscles to contract tightly and painfully (spasm). It is also possible for your muscles to stay contracted and become stiff and resistant to movement, which is known as spasicity.

Pain

There are two types of pain which can occur as a result of MS; neuropathic and musculoskeletal.

Neuropathic pain is caused by damage to the nerve fibers in your central nervous system, and appears as stabbing pains, extreme skin sensitivity or burning sensations. Musculoskeletal pain is not caused directly by MS, but can occur if there is excess pressure on your muscles or joints as a result of spasms and spasicity.

Mobility problems

MS can affect your balance and coordination, and can cause you difficulty walking and moving around, particularly if you also have muscular spasms and spasicity. You may also experience a tremor (ataxia), or dizziness, which can be quite severe and make it feel like your surroundings are spinning (vertigo).

Cognitive problems

Cognitive problems refer to problems with mental processes such as thinking and learning. You may have trouble remembering and learning new things, problems with attention and concentration, slowed or confused speech, and reduced mental speed.

Emotional problems

If you have MS, you may find that you laugh or cry for no reason, and you may also be more likely to experience depression or anxiety.



Fatigue and tiredness

If you have MS, you may find that extreme tiredness (fatigue) is your main symptom. You may find that fatigue worsens your other symptoms, such as problems with balance, vision and concentration.

Bladder problems

MS can make your bladder either overactive or underactive. If it is overactive, your bladder may contract when it is not full, causing incontinence. If it is underactive, you may find that your urine flow is interrupted and your bladder does not feel empty.

Bowel problems

MS can often cause constipation, but you may also find that it causes bowel incontinence as well.

The symptoms of MS are unpredictable, and some people may find that their symptoms develop and worsen steadily over time, while for others they come and go periodically.

Periods when your symptoms get worse are known as relapses, and periods when your symptoms improve, or disappear altogether, are known as remissions.

A relapse in MS is defined as a period of at least 24 hours, during which new symptoms appear, or your previous ones worsen. Relapses can occur at any time, and may vary in their severity with each recurrence. In some cases, a recurrence or worsening of your symptoms can be caused by outside factors such as hot weather, exercise or an infection.

The four types of MS are characterized by the patterns of relapses and remissions that your symptoms follow, and are outlined below.

Benign MS (BMS)

Benign MS (BMS) is the mildest form of MS which is characterized by a small number of relapses followed by a complete recovery each time. However, if you have benign MS, there is no guarantee that it is ever gone for good.

It is possible to have a relapse of your symptoms after many years of benign MS.

Relapsing remitting MS (RRMS)

Relapsing remitting MS (RRMS) is the most common type of MS, and it is characterized by numerous relapses and remissions. Your relapses may last for days, weeks or months, and you may experience new symptoms each time, or a recurrence of previous ones.

After each relapse, you may recover completely, but many people's symptoms only improve without disappearing altogether.

Secondary progressive MS (SPMS)

Secondary progressive MS (SPMS) is characterized by a steady worsening of your symptoms, with or without relapses. Most people who have RRMS go on to develop this form of MS.

Primary progressive MS (PPMS)

Primary progressive MS (PPMS) is the most severe form of MS. If you have this form of MS, your symptoms will get steadily worse with no distinct relapses, or remissions.

Updated as of Sep 8 2008