From the Guidelines
Multiple sclerosis (MS) symptoms include fatigue, numbness or tingling in limbs, muscle weakness or spasms, difficulty walking or maintaining balance, vision problems, and cognitive issues, among others, as noted in the 2018 espen guideline clinical nutrition in neurology study 1. The symptoms of MS can vary widely depending on which nerve fibers are affected. Common symptoms include:
- Fatigue, which affects a significant portion of patients
- Numbness or tingling in limbs
- Muscle weakness or spasms
- Difficulty walking or maintaining balance
- Vision problems like blurred vision or double vision
- Cognitive issues such as memory problems or difficulty concentrating Many patients also experience:
- Bladder and bowel dysfunction
- Sexual problems
- Pain
- Depression
- Heat sensitivity It is essential to note that MS symptoms typically appear in episodes called relapses that last days to weeks, followed by periods of remission, as described in the study 1. However, some patients experience progressive worsening without distinct relapses. The cause of MS is unknown, but research suggests that genetic, immunological, and environmental factors, such as a common virus, may all be involved in a complex etiology, as mentioned in the study 1. Weight loss, malnutrition, and even cachexia are well-recognized features of patients with MS, with possible causes including reduced mobility and fatigue, inappropriate diet, physical difficulty for eating or drinking, poor appetite, poor sight, reduced cognition, and dysphagia, as noted in the study 1. Early recognition of these symptoms is crucial for diagnosis and treatment, as modern disease-modifying therapies can significantly slow disease progression when started early, emphasizing the importance of prompt consultation with a healthcare provider if persistent neurological symptoms are experienced.
From the Research
Symptoms of Multiple Sclerosis (MS)
The symptoms of MS can have disabling functional consequences for patients and lead to significant reductions in their quality of life 2. Some common symptoms include:
- Unilateral optic neuritis
- Partial myelitis
- Sensory disturbances
- Brainstem syndromes such as internuclear ophthalmoplegia
- Fatigue
- Depression
- Cognition problems
- Neuromuscular functions such as gait, muscle strength, and spasticity
- Sensory function such as balance 3, 4
Symptom Management
MS symptoms can interact with each other, making their management challenging 2. A stepped approach to symptom management starts with healthy lifestyle practices and adds nonpharmacologic, pharmacologic, and procedural-based therapies balancing levels of evidence, risks, and potential benefits 5. Some therapies used for symptom management include:
- Pharmacologic therapies such as interferons, glatiramer acetate, teriflunomide, sphingosine 1-phosphate receptor modulators, fumarates, cladribine, and monoclonal antibodies 4
- Complementary and alternative therapies such as mindfulness, yoga, and reflexology 3
- Lifestyle modifications that enhance central nervous system reserve and function, such as healthy nutrition and exercise 6, 5
Impact of Symptoms on Quality of Life
MS symptoms can affect quality of life and daily activity, and treatment with disease-modifying therapies (DMTs) can reduce the annual relapse rate by 29% to 68% compared with placebo or active comparator 4. Overall life expectancy for people with MS is less than in the general population, and MS more commonly affects women 4.