From the Guidelines
Multiple sclerosis (MS) symptoms vary widely between individuals but commonly include fatigue, numbness or tingling in limbs, vision problems, balance issues, and muscle weakness. Many patients experience walking difficulties, cognitive changes (like memory problems or difficulty concentrating), bladder and bowel dysfunction, and pain. MS symptoms often appear in episodes called relapses or flare-ups, followed by periods of remission, though some forms of MS are progressive without clear remissions. Early symptoms might include blurred or double vision, thinking problems, clumsiness, or weakness in one limb. The disease causes the immune system to attack the protective covering of nerve fibers (myelin), disrupting communication between the brain and body. Symptoms typically appear between ages 20 and 40 and affect women more frequently than men. The severity and specific combination of symptoms depend on which nerve fibers are damaged and the extent of damage. If you experience persistent neurological symptoms, especially vision changes, weakness, or numbness, seek medical attention promptly as early diagnosis and treatment can help manage symptoms and potentially slow disease progression, as suggested by the most recent guidelines 1.
Some key points to consider:
- 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 1.
- The diagnosis of MS is based on the detection of lesions within the CNS that demonstrate dissemination in space (DIS) and dissemination in time (DIT), with the current diagnostic criteria requiring exclusion of alternative diagnoses that can mimic MS either clinically or radiologically 1.
- The 2010 McDonald criteria have substantially improved the diagnostic process in relapsing–remitting MS (RRMS), but they exhibit a number of limitations in primary progressive MS (PPMS) 1.
- Obtaining objective evidence of dissemination in time and space of lesions typical of MS is essential in making a secure diagnosis, as is the exclusion of other, better explanations for the clinical features 1.
Overall, early recognition and diagnosis of MS are crucial for effective management and treatment, and a comprehensive diagnostic evaluation should include a combination of clinical, radiological, and laboratory investigations to confirm the diagnosis and rule out other potential causes of symptoms 1.
From the Research
Symptoms of Multiple Sclerosis (MS)
The symptoms of Multiple Sclerosis (MS) can vary widely, but some common symptoms include:
- Impaired motor function 2
- Sensory deficiencies 2
- Cognitive decline 2
- Numbness 3
- Tingling 3
- Weakness 3
- Vision loss 3
- Gait impairment 3
- Incoordination 3
- Imbalance 3
- Bladder dysfunction 3
- Fatigue 3
- Heat sensitivity 3
- Pain 4
- Sphincter disorders 4
- Spasticity 4
- Insomnia 5
- Influenza-like syndrome 5
- Asthenia 5
- Headache 5
- Myalgia 5
- Hypoesthesia 5
- Nausea 5
- Paresthesia 5
- Myasthenia 5
- Chills 5
- Depression 5
Disease Progression
MS can progress in different ways, including:
- Relapsing-remitting MS, characterized by discrete episodes of symptoms followed by periods of remission 5, 3
- Progressive MS, characterized by a gradual worsening of symptoms over time 3
- Secondary-progressive MS, characterized by a gradual worsening of symptoms after an initial relapsing-remitting course 5
Impact on Quality of Life
MS can have a significant impact on a person's quality of life, including: