By Dr. Fateh Malik
1-Fatigue: Some 80% of people with multiple sclerosis disease will experience fatigue at one point or another, but fatigue can have many causes. Some people experience “MS lassitude,” a very severe fatigue that occurs daily that tends to get worse as the day wears on. “People describe it as unlike anything they’ve ever felt,” says Rosalind Kalb, Ph.D., vice president of the Professional Resource Center at the National multiple sclerosis disease Society in New York Ci
2-Numbness: Numbness (or a lack of sensation in various parts of the body) is often one of the first symptoms of multiple sclerosis disease. Numbness can occur in the face, the body, or the arms and legs, and can interfere with walking, holding on to objects, and even chewing, if the numbness affects the face. Sometimes the feeling—or lack thereof—progresses over hours or days, but it usually subsides on its own.
3-Tingling : Tingling is related to numbness and may feel like your arm, fingers, or toes are falling asleep, yet never quite waking up. Like other symptoms of multiple sclerosis disease, this is a result of damaged nerves sending mixed signals to the different parts of the body. People may also experience something called the “MS hug.” “It feels like somebody is grabbing them very tightly around the midsection, but it’s not muscular,” says Kalb, who is also principal author of MS For Dummies. “It’s a sensory phenomenon that feels like this tight banding.”
4-Balance and coordination problems: Movement problems are a hallmark of MS. “Impaired nerve conduction means muscles are not behaving the way they used to,” explains Kalb. People may report they feel suddenly weak in one limb or they may find objects slipping easily out of their hands. If there’s damage to the cerebellum, the part of the brain that controls balance, people might also be unsteady on their feet and prone to falling.
5-Spasticity: Spasticity can involve both stiffness as well as involuntary muscle contractions. As a symptom of multiple sclerosis disease, it’s most common in the legs and may manifest as a mild feeling of tightness in the muscles or as more severe pain. In extreme cases, spasticity can cause a person’s body to become distorted and twisted, almost as if they’re folded up like a pretzel. The symptom often goes hand-in-hand with weakness of the limbs or other parts of the body.
6-Vision problems: Like numbness, vision problems are one of the most common early symptoms of multiple sclerosis disease prompting a person to visit the doctor. The problem can manifest as double vision, eye pain, blurred vision, or a scotoma (it looks like a hole in your vision). Thesesymptoms of multiple sclerosis disease usually result from optic neuritis or inflammation of the optic nerve, says Mark Keegan, M.D., associate professor of neurology at the Mayo Clinic in Rochester, Minn. Although vision problems can interfere with working and driving, they do tend to resolve on their own.
7-Pain: “The majority of people with multiple sclerosis disease do experience pain related to their MS,” says Kalb. The pain is often the direct result of nerves damaged by the disease. If this is the case, the person may feel severe burning sensations in their legs, feet or hands, or might imagine a knife is stabbing the side of his or her face because the nerves on that side are inflamed. But pain can also be musculoskeletal, resulting not from nerve damage, but from impaired gait that causes misalignment of the hips and spine.
8-Bladder dysfunction: Bladder problems in people with multiple sclerosis disease can manifest in two, seemingly opposite ways. Some people have difficulty emptying their bladder. That means urine stays too long in the bladder, leading to infection, discomfort, and a distended bladder. Or people might have the opposite problem with the bladder responding to even the tiniest bit of fluid. “You’re always feeling like you have to go to the bathroom but there’s nothing there,” says Kalb. The brain is either telling the bladder it’s full when it’s empty, or signaling it’s empty when it’s full.
9-Constipation: The most common bowel problem related to multiple sclerosis disease is constipation. “This is because the nerves and muscles are not doing what we most of the time take for granted, which is moving things efficiently through the system,” Kalb says. The problem can be compounded if the person also has bladder dysfunction and is cutting back on water. “That only contributes to the constipation problem,” Kalb says.
10-Speech and voice disorders: Up to 40% of people with MS experience problems with their voice or speech.One possible problem is dysarthria, a motor speech problem that manifests as slurring, poor articulation of words, and speaking too loudly or too softly. Another possibility is dysphonia, a change in voice quality, such as sounding hoarse or nasal.
11-Depression: Not surprisingly, depression is common among people with Multiple Sclerosis Disease. Changes in the immune system can contribute to depression, as can biochemical changes in the brain. But simply living with a chronic, unpredictable disease can trigger depression. “The most important thing for people with MS and their families to understand is that this is not about being weak or crazy or somehow emotionally damaged,” says Kalb. “This is a symptom of Multiple Sclerosis Disease just like any other symptom that needs to be appropriately treated.”
12-Cognitive dysfunction: Cognitive dysfunction affects upwards of 60% of people with Multiple Sclerosis Disease, says Kalb. The good news is that only specific areas are affected. This could be recent or “working” memory or the speed at which a person is able to process information. Or a person may have trouble focusing or multi-tasking. Once these problems start, they often don’t go away, but they do progress slowly. “With appropriate diagnosis and strategies for managing, people can stay ahead of it and use compensatory strategies,” says Kalb. Cognitive changes are severe for only a small percentage of people.
13-Anxiety: This is the “poor second cousin to depression,” says Kalb. That’s because depression gets all the attention, though anxiety can be equally debilitating. Not only are there organic changes in the brain that result in anxiety, but the ongoing, uncertain nature of Multiple Sclerosis Disease can be nerve-wracking.MS can also involve mood swings and irritability, although the irritability may be a consequence of depression.
14-Emotional changes: About 10% of people with Multiple Sclerosis Disease may experience “pseudobulbar affect” (PBA), a neurologic change that usually occurs in tandem with cognitive changes. Here, the expression of a mood or feeling is disconnected from how a person’s actually feeling so a person may have uncontrolled bouts of crying when they’re not actually sad or they may laugh hysterically at inappropriate times.
15-Dizziness and vertigo: Fortunately, dizziness and vertigo aren’t among the most common symptoms of multiple sclerosis disease as they can be, Kalb says, “truly awful.” At their worst, people feel they “can’t get the world to stop spinning and have to stay in bed until it goes away,” she adds. The good news is that the symptoms of multiple sclerosis disease moften do go away and, for others, common drugs used to treat dizziness and vertigo in otherwise healthy people can be effective.