MUSC Multiple Sclerosis Clinic : About Multiple Sclerosis : Symptoms

Symptoms in MS tend to come on over a period of days to weeks and peak. Usually the symptoms remit after a variable period of time, again, usually days to weeks.

Sensory:

• May be present in any part of the body and any combination.
  Might be loss of sensation, including decreased pain, temperature, touch or position sense.
• May be manifest by tingling, pins and needles sensation, or even burning or other painful sensations.

Visual:

The most common visual manifestation is optic or retrobulbar neuritis.
It usually presents with eye pain, which is more pronounced during eye movements and visual loss ranging from only color perception difficulties to total blindness.

Eye movements can be affected in MS. This can result in double vision or blurred vision.

Motor deficits may present as weakness, spasticity or incoordination.
They may be associated with atrophy and/or spasms and spasticity.
Motor deficits may be located in any region, in the upper and lower limbs
and/or torso. The secondary complications from these can result in impaired mobility, decreased dexterity, gait dysfunction as well as joint contractures, pain, disturbed sleep and difficulties with maintaining hygiene.

Fatigue is one of the most frequent symptoms of MS causing disability.
It has multiple characteristics including general, chronic lack of energy, muscle fatigue and tiredness.
It generally occurs after morning hours, in the early or late afternoon.
It may result in an overwhelming need to sleep.

MS can affect several cranial nerves producing loss of taste, facial weakness
and sensation, hearing loss, tinnitus (ringing in the ear) or vertigo (dizziness). Control of ocular muscles can be affected and result in blurred or double vision (see above). Other cranial nerve involvement can result in slurred speech and/or difficulty swallowing.

Bladder, bowel and sexual dysfunction:

• Bladder problems frequently present as either hyperactivity or failure to empty the bladder with overflow. This can result in urinary urgency, frequency, incomplete voiding or incontinence. The failure of the bladder to empty may present with urinary hesitancy, urinary retention or overflow incontinence. These bladder symptoms must be differentiated from those caused by urinary tract infection, which is also frequently seen in MS.
• Bowel dysfunction is also common. It usually manifests as constipation or it may rarely present as bowel urgency and incontinence.
• Sexual dysfunction affects both sexes, and originates from loss of perineal sensation, incontinence, neuropathic pain and/or depression. In males it may present as erectile dysfunction and in women as loss of libido or inability to experience orgasm.

Pain:

Pain is a frequent problem in MS. However, it is unusual to be a presenting symptom or dominate the clinical course. Localized pain can originate from inflammatory processes at the site of the lesion such as the optic nerve, spinal cord or spinal nerve roots. Neuropathic pain can occur in the distribution of a nerve root ( as sharp, shooting pain ) or occur in limbs in a random fashion. Pain can result from orthopedic type problems which can occur secondary to weakness, impaired gait or injury.

Causes a temporary worsening of symptoms and may make your vision blurry or some other symptom worsen temporarily (Uhthoff's phenomenon). Body functions normalize when the body cools off.

Visit MUSC's Health Information Library for more information about multiple sclerosis.