What are the symptoms of Multiple Sclerosis (MS)?

From the Guidelines

Multiple sclerosis (MS) symptoms can vary widely, but common symptoms include fatigue, numbness or tingling in limbs, vision problems, muscle weakness, coordination and balance difficulties, and problems with speech, as noted in the 2015 study by 1. The symptoms of MS can be diverse and depend on the nerve fibers affected. According to the study by 1, common symptoms include:

• Fatigue
• Numbness or tingling in limbs
• Vision problems (blurred vision, double vision, or partial/complete vision loss)
• Muscle weakness
• Coordination and balance difficulties
• Problems with speech Many patients experience electric-shock sensations with certain neck movements (Lhermitte's sign). Cognitive changes like memory problems, difficulty concentrating, and slowed thinking affect about half of MS patients. Bladder and bowel dysfunction, sexual problems, dizziness, tremors, and emotional changes such as depression are also frequent. MS symptoms typically appear as episodes or attacks (relapsing-remitting MS) but can progressively worsen over time in some forms of the disease. Heat and stress often temporarily worsen symptoms. The variability of symptoms makes MS challenging to diagnose, as the disease damages the protective myelin sheath around nerve fibers in the brain and spinal cord, disrupting communication between the brain and the rest of the body. Early recognition of these symptoms is crucial for prompt diagnosis and treatment, as emphasized by the diagnostic criteria outlined in the study by 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), as well as the exclusion of alternative diagnoses that can mimic MS either clinically or radiologically, according to the study by 1. The 2010 McDonald criteria, discussed in the study by 1, have increased the sensitivity of the criteria and simplified the features of both DIS and DIT, while maintaining the specificity of the earlier versions of the criteria. The use of MRI is essential in supporting the clinical diagnosis and ruling out other disorders, as noted in the study by 1.

In terms of diagnosis, the study by 1 emphasizes the importance of obtaining objective evidence of dissemination in time and space of lesions typical of MS, as well as the exclusion of other, better explanations for the clinical features. The study by 1 also highlights the importance of considering the clinical presentation, MRI findings, and other diagnostic tests, such as cerebrospinal fluid (CSF) testing, in making a diagnosis of MS. The diagnosis of MS should be made based on a combination of clinical and paraclinical evidence, as outlined in the study by 1.

Overall, the symptoms of MS can be diverse and challenging to diagnose, but early recognition of these symptoms is crucial for prompt diagnosis and treatment. The use of MRI and other diagnostic tests, in combination with clinical evaluation, is essential in supporting the diagnosis and ruling out other disorders. The 2010 McDonald criteria, as discussed in the study by 1, provide a useful framework for diagnosing MS, but should be used in conjunction with clinical judgment and expertise.

From the Research

Symptoms of Multiple Sclerosis

The provided studies do not directly discuss the symptoms of multiple sclerosis. However, they do mention the effects of different treatments on the disease course and outcomes.

Treatment Outcomes

• The studies compare the efficacy of interferons-beta (IFNs-beta) and glatiramer acetate (GA) in the treatment of relapsing-remitting multiple sclerosis (RRMS) 2, 3.
• Both therapies show similar clinical efficacy at 24 months, but IFNs-beta may limit the increase in lesion burden as compared to GA 2, 3.
• The reduction in T2- and T1-weighted lesion volume is significantly greater in the groups given IFNs-beta than in the GA groups 2, 3.

Adverse Events

• The number of participants who dropped out of the study due to adverse events is similar in the IFNs-beta and GA groups 2, 3.
• Common adverse events associated with IFNs-beta include injection site reactions and flu-like symptoms 4, 5.
• Patient education and mitigation strategies are key to managing these adverse events and supporting therapy adherence 5.

Treatment Options

• There are several IFNβ drugs approved to treat relapsing forms of MS, including subcutaneous IFNβ-1b, subcutaneous IFNβ-1a, intramuscular IFNβ-1a, and peginterferon beta-1a 5.
• Peginterferon beta-1a has an extended half-life and requires less frequent administration than other available treatments 5.
• Switching among these therapies may be a viable option for patients who experience issues with tolerability 5.