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Medical Author:

Fernando Dangond, MD

Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The symptoms of multiple sclerosis can be different from person to person. Visual, sensory, and motor signs and symptoms are all part of multiple sclerosis. The clinical manifestations are varied, and therefore there is a wide range of symptoms that can appear. Some people have mild cases of multiple sclerosis with little or no disability over the years. Others have more severe types of multiple sclerosis, requiring confinement to a wheelchair or bed. Still others may live their entire lives symptom-free (some individuals without multiple sclerosis symptoms are found incidentally to have multiple sclerosis lesions by MRI, or individuals in whom an examination of their brain after death unexpectedly reveals that they were affected by the disease). This variability makes it difficult in some cases to diagnose multiple sclerosis. Often the signs and symptoms are mistaken as being psychiatric in origin.

• The first symptoms of multiple sclerosis are often visual changes.
  
  
  • Large number of people with multiple sclerosis develop optic neuritis (inflammation of the optic nerve, which is an extension of the central nervous system), described as a painful vision loss. If a patient is diagnosed with optic neuritis early, treatment could change the course of the disease.
    
    
  • Before the actual loss of vision, the patient may have visual changes described by many people as blurred or hazy vision, flashing lights, or alterations in color.
    
    
  • The tissues around the eye and moving the eye may be painful.
    
    
  • Most people recover over several months. Others are left with permanent visual defects.
    
    
  • Double vision occurs when the eyes move in different directions and is another common symptom of multiple sclerosis.
  
  
• Multiple sclerosis commonly affects the cerebellum, the portion of the brain responsible for balance and fine motor coordination. Consequently, people with multiple sclerosis often have difficulty maintaining their balance when walking and performing delicate tasks with their hands. Unexplained dropping of a cup or other object or unusual weakness can occur.
  
  
• Patients may experience facial pain, a sensation of spinning referred to as vertigo, and sometimes hearing loss.
  
  
• Virtually any area of the body can be involved, making this disease the great imitator of other disorders of the nervous system.
  
  
  • The patient may experience painful muscle spasms or loss of strength in one or more of the arms or legs.
    
    
  • The nerve fibers that conduct touch, pain, and temperature sensations are often affected, causing tingling, numbness or electrical-type pain sensations in the chest, abdomen, arms or legs.
  
  
• Multiple sclerosis can involve the nerves responsible for involuntary actions of the bladder and intestines.
  
  
  • The patient may often have constipation and urinary retention.
    
    
  • These symptoms lead to other complications, such as infections of the bladder, kidney, or blood.
  
  
• Most people with multiple sclerosis complain of a constant state of tiredness. Something as simple as carrying groceries up a flight of stairs may become an impossible task for someone with multiple sclerosis.
  
  
• A peculiar trait of multiple sclerosis is the relationship between higher temperatures and the worsening of symptoms.
  
  
  • People often complain of worsening of any of their symptoms after taking a hot shower, or participating in strenuous exercise.
    
    
  • The exact reason this occurs is unknown. Perhaps it is because at higher temperatures nerve conduction decreases, which could lead to further slowing in the transmission of messages in nerves that have already lost myelin.

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