|Get the annotated audio of this post in MP3 and WAV formats to listen on your computer or portable device of your choice!
Enhance your learning and convenience through repetitive offline listening!
Signs and symptoms of MS (multiple sclerosis) are clinical features of the disease. They are, if you will, personality traits of the disease. Patients experience them in the form of symptoms. Health care providers, others, and in some cases, the patients themselves observe signs.MS starts out as a disease of the myelin sheath of nerves. But it later progresses to cause damage to the nerve fibers themselves. As a result signs and symptoms tend to evolve over time.
The signs and symptoms of MS in a given person depend on the sites and severity of the disease. There are particular features which are more prevalent early on. Others increase in frequency the longer the disease is present.
The different signs and symptoms might involve a host of altered functions of the nervous system in general, even though it is a disease of the central nervous system. The reason is the peripheral nervous system must have good connections to the brain to properly carry out its functions.
Early Symptoms of MS
Early symptoms of MS are the initial ones that the disease causes. They vary from person to person. Population data gives a pretty good idea of what they are in general though. An accomplishment to this end has been the work of the group, MS in America.
MS in America is an online surveying group. It conducted valid online surveys of 5710 people with MS in 2014 and of more than 5000 people with the disease in 2016. The 2014 survey consisted of 156 questions covering a broad range of topics including symptoms the patient’s experienced well prior to their diagnoses of MS. The survey in 2016 consisted of 115 questions. But it also included those about symptoms experienced prior to the diagnosis. The symptoms and their relative frequencies for 2016 and 2014 respectively are depicted below:
Of the survey respondents in 2016, 39% began having symptoms prior to 30 years of age.
The numbness or tingling of MS might be in any part of the body or face. In addition, MS patients might experience the sensation of tingling as a part of Lerhmitte’s sign.
The mechanism of fatigue is unknown, even though it is one of the more common symptoms of MS. It tends to be present on a daily basis and worsens as the day goes on. It is for the most part worse than tiredness due to other causes.
Walking problems are due to either or a combination of the following:
- Gait ataxia
- Decreased sensation, particularly proprioceptive sensation
- Muscle weakness
Visual symptoms of MS can be either or a combination of the following:
Muscle weakness of MS can involve muscles of any part of the body. It can be due to deconditioning from lack of use or from the damage of nerve fibers in the spinal cord and brain affected by the demyelinating process.
Dizziness and vertigo which some MS patients experience are due to damage to the complex nerve pathways in the brain and spinal cord which carry and coordinate signals that produce and maintain equilibrium.
The above 2016 report and some studies by others suggest an increased incidence of migraine and other types of headaches in people with MS. The details are not clear. But a family history of migraines observed in about 20% of one sample group suggests that there might be a genetic factor that predisposes to both MS and migraine headaches.
Pain occurs at some point during the disease and the majority of patients with MS. It can occur anywhere in the body. There are many proposed mechanisms for it, but the acute pain early on appears to be due to faulty signals in the brain and spinal cord as a result of demyelination. Trigeminal neuralgia is a common cause of early MS pain in the face. Other more complex factors, including muscle spasms, are involved in the chronic pain of MS.
Muscle spasms are the sustained involuntary muscle contractions and sudden movements resulting from them. The movements can be of any limb, but is more common in the legs. They might consist of flexion or extension. They are a part of spasticity – excessive muscle tone – which is fairly common early on, but more so in the latter stages of the disease.
Cognitive symptoms of MS manifest as the hindrance of one or more of a range of high level brain functions. They include the following:
- Memory (acquiring, retaining and retrieving new information)
- Processing information (handling information received by one or more of the five senses)
- Attention and concentration
- Verbal fluency (fluent speaking without searching for words)
- Executive functions (planning, organizing, problem solving and prioritizing)
- Visuospatial functions (the ability to identify the spatial aspects of a shape or item in two or three dimensions)
Other Common Symptoms of MS
The MS in America survey for 2017 was of 5,311 individuals with MS. It yielded a breakdown of the symptoms they had experienced since their diagnoses of the disease. Those symptoms and their frequencies were as follows:
- Urinary incontinence
- Urinary frequency
- Urinary hesitancy
- Urinary urgency
- Incomplete bladder emptying
Sexual dysfunction might be in the form of:
- Decreased libido (sex drive) in the case of men or women
- Erectile dysfunction in men
- Vaginal dryness in women
Bowel problems can be:
In addition to depression and anxiety there are other emotional symptoms of MS. They include:
- Mood swings
- Uncontrolled crying
- Uncontrolled laughing
Less Common Symptoms of MS
Finally, breathing difficulties can be a rare symptom of MS. When present it is due to weakness of the muscles of respiration.
Signs of MS
There are two types of signs of MS. The first type is a clue which a physical examination reveals. The other type is more complex. It is a combination of physical signs and/or symptoms of another disease which frequently accompanies or precedes MS. It might also be that disease itself. But in some instances it may stand on its own in the absence of MS. The significance of both types of signs is relative to space and time.
Physical signs of MS help doctors to make a diagnosis. MS is not the sole cause of those signs though. Some of the more common physical signs of MS are as follows:
- Positive Babinski reflex
- Hyperreflexia – one or more overactive deep tendon reflexes
- Internuclear ophthalmoplegia
- Lerhmitte’s sign
- Muscle weakness
- Limb or gait ataxia
Some of the common more complex signs which are possible indicators of MS are the following:
- Central facial nerve palsy
- Clinically isolated syndrome
- Optic neuritis – inflammation of the optic nerve
- Trigeminal neuralgia
- Overactive bladder