Multiple sclerosis symptoms generally appear between the ages of 20 and 40.
Demyelination, or deterioration of the protective sheath that surrounds nerve fibers (called myelin), can occur in any part of the brain or spinal cord. The types of symptoms, severity of symptoms, and the course of MS vary widely depending on the affected area.
Demyelination in the nerve pathways that send messages to the muscles causes problems with movement (motor symptoms), while demyelination along the pathways that carry sensory messages to the brain causes disturbances in sensation.
The most common symptoms are:
- Tingling or numbness in the arms and legs
- Loss of balance
- Weakness
- Difficulty walking
- Blurred or double vision
- Bladder and bowel control problems
- Fatigue
- Changes in thinking or perception
- Sexual disturbances
Less common symptoms might include:
- Slurred speech
- Sudden onset of paralysis
- Lack of coordination
As the disease progresses, heat sensitivity might be another symptom.
In many people, the disease starts with a single symptom, followed by months or even years without any progression of symptoms. In others, the symptoms might become worse within weeks or months.
About the first 10 years after the illness begins, symptoms tend to fluctuate with periods of remission (no signs of the disease) and relapse (recurring disease). Over half of MS patients gradually develop increasing neurologic disability that can lead to impaired mobility, vision, and coordination.
What are the types of symptoms?
It is helpful to divide the symptoms into three categories: primary, secondary, and tertiary.
Primary symptoms are a direct result of demyelination. This impairs the transmission of signals to muscles and other organs. The symptoms include weakness, tremors, tingling, numbness, loss of balance, vision impairment, paralysis, and bladder or bowel dysfunction. Medicine, rehabilitation, and other medically based methods can help keep many of these symptoms under control.
Secondary symptoms are the result of the primary symptoms. For example, paralysis can lead to bedsores (pressure sores) and bladder dysfunction can cause frequent, recurring urinary tract infections. These symptoms can be treated, but the ideal goal is to avoid them by treating the primary symptoms.
Tertiary symptoms are the social, psychological, and vocational complications associated with the primary and secondary symptoms. Depression, for example, is a common problem among MS patients.
Are symptoms the same in every patient?
Multiple sclerosis follows a varied and unpredictable course. It is important to understand that although a wide range of symptoms can occur, a given individual might experience only some of the symptoms and never have others. Some symptoms might occur once, resolve, and never return. Because MS is such an individual disease, it is not helpful to compare yourself with other MS patients.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/15/2005
