From the Guidelines
Multiple sclerosis can cause symmetric symptoms, although asymmetric symptoms are more characteristic of the disease. The presentation of multiple sclerosis (MS) can vary significantly among patients, with some experiencing bilateral or symmetric symptoms, particularly in certain presentations like primary progressive MS 1. Symmetric symptoms might include bilateral weakness in the legs, symmetric sensory disturbances, or balance problems affecting both sides equally. This variability occurs because MS lesions can develop in any part of the central nervous system, including areas that control functions on both sides of the body, such as the spinal cord.
Some key points to consider when evaluating the potential for symmetric symptoms in MS include:
- The location of demyelination and nerve damage: When lesions affect the spinal cord or certain brain regions that control bilateral functions, symmetric symptoms can result 1.
- The pattern of symptoms: This depends on the location of demyelination and nerve damage, and can include a range of symptoms such as weakness, sensory disturbances, and balance problems 1.
- The importance of comprehensive neurological evaluation: Diagnosis of MS can be challenging, and requires a comprehensive evaluation including MRI imaging, spinal fluid analysis, and clinical assessment 1.
It's also important to note that while symmetric symptoms can occur in MS, they are not as common as asymmetric symptoms, and other conditions such as leukodystrophy or cerebrovascular disease should be considered in the differential diagnosis if symmetric symptoms are present 1. In summary, while MS typically causes asymmetric symptoms, symmetric symptoms can occur, particularly in certain presentations, and a comprehensive neurological evaluation is necessary to diagnose and manage the disease effectively.
From the Research
Multiple Sclerosis Symptom Presentation
- Multiple sclerosis (MS) is a neurodegenerative disease characterized by inflammatory demyelination with axonal transection, and it can present with various symptoms, including unilateral optic neuritis, partial myelitis, sensory disturbances, or brainstem syndromes 2.
- Typical symptoms of MS include discrete episodes of numbness, tingling, weakness, vision loss, gait impairment, incoordination, imbalance, and bladder dysfunction 3.
- While MS symptoms can be asymmetric, such as unilateral optic neuritis, the disease can also cause symmetric symptoms, although this is not explicitly stated in the provided studies.
Disease Characteristics and Diagnosis
- MS is diagnosed based on demonstrating evidence of inflammatory-demyelinating injury within the central nervous system that is disseminated in both time and space 3.
- Diagnosis is made through a combination of the clinical history, neurologic examination, magnetic resonance imaging, and the exclusion of other diagnostic possibilities 3.
- The disease can progress with an insidious worsening of neurologic function and accumulation of disability, which accounts for most of the long-term disability in MS 3.
Treatment and Management
- Several disease-modifying therapies (DMTs) are available for relapsing-remitting MS and secondary progressive MS, including interferons, glatiramer acetate, teriflunomide, sphingosine 1-phosphate receptor modulators, fumarates, cladribine, and monoclonal antibodies 2, 4.
- These DMTs can reduce clinical relapses and MRI lesions, but their efficacy rates vary, and they can have adverse effects 2, 4.
- Switching to a different DMT, such as fingolimod, can be associated with fewer relapses, more favorable disability outcomes, and greater treatment persistence compared to switching to another injectable preparation 5.