Symptoms of Multiple Sclerosis
Multiple sclerosis (MS) is a neurodegenerative disorder caused by the immune system mistakenly attacking the myelin sheath, or the protective protein coat around nerve fibers. This results in inflammation, which further damages the myelin sheath as well as the nerve cells themselves, and the cells that produce myelin.
The immune system attack on myelin causes a disruption in electric signals traveling along the nerve fibers from the brain to the body and back. As a result, patients with MS can experience a variety of symptoms, including fatigue, numbness and tingling, muscle spasms, walking difficulties, pain, and bowel or bladder problems. Many people with MS also experience emotional changes, including depression, anxiety, and mood swings. While many or these symptoms are common to MS patients, their severity and nature can vary widely.
Some of the symptoms MS patients may experience are summarized below.
Bladder dysfunction in MS can range from frequent urination to urinary incontinence, an inability to fully empty the bladder, and urinary infections. These problems usually develop as the disease progresses, typically six years on average after diagnosis. Bladder problems are related to lesions that block or delay the transmission of nerve signals in areas of the central nervous system that control the bladder, and are worsened by a patient’s reduced mobility.
Bowel problems with MS are relatively common. Typically, MS patients experience constipation more than bowel incontinence, since the bowel is more often affected by the brain failing to relay messages that it is time to have a bowel movement. However, in the case of bowel incontinence, reduced sensation in the rectum or reduced control of the anus can lead to a lack of ability to control bowel movements.
Dysesthesia is the name given to altered, unpleasant, and possibly painful sensations that MS patients can experience, frequently described as a burning and aching feeling or, if affecting the trunk, a “girdling” sensation across the body (popularly known as the “MS hug”). These sensations have a neurologic origin and can affect any part of the body, but are most common in the face, arms or legs, and trunk.
Lhermitte’s sign is a sudden, intense feeling like that of an electric shock, triggered in people with MS when they move or flex their neck in a wrong way. The shock sensation can pass down the neck into the spine, and radiate into the arms and legs and, possibly, the trunk. Lhermitte’s sign is due to the damage MS causes to the nerves, particularly demyelination and hyperexcitability.
With MS, some people may experience a condition known as pseudobulbar affect — a sudden burst of uncontrollable laughter or crying, often with no triggering event. This is caused by damage or injury to parts of the brain that regulate emotional expression. It may also involve the disruption of cellular communication. Although people with pseudobulbar affect are expressing emotion, it is involuntary and they may not be feeling that emotion.
Sexual relations are a sensitive — and difficult — topic for people with MS, just as they are for people in general. But in multiple sclerosis, damage to nerve impulses can directly affect arousal and orgasm, while spikes in symptoms like emotional stability and moodiness, or fatigue or spasticity, can make mutually satisfying sexual relations between adults somewhat challenging.
Spasticity, one of the most common symptoms of MS, causes muscles to feel stiff and heavy, making movement difficult. It is characterized by an abnormal increase in muscle tone or stiffness that affects walking, balance, and occasionally speech. It is a challenging symptom because it may or may not happen regularly, its manifestations can differ from person to person, and they can even differ in the same person at various times.
Vision problems in MS can range from optic neuritis and blurred vision to double vision, involuntary or jerky eye movements or, on occasion, a total loss of sight. Complete blindness, however, is rare. These symptoms generally are caused by damage to the optic nerve, which carries information between the eyes and the brain, or from poor coordination of eye muscles so that the eyes do not move together or move well together.