Symptoms
MS symptoms are variable and unpredictable. No two people have exactly the same symptoms, and each person’s symptoms can change or fluctuate over time. One person might experience only one or two of the possible symptoms while another person experiences many more.
Often, when symptoms first start to happen, they come and go, and are quite mild. They often are not serious enough to need medical attention. Sometimes it is only after people have been diagnosed with MS that they realise they were having early symptoms before.
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Fatigue - Occurs in about 80% of people, can significantly interfere with the ability to function at home and work, and may be the most prominent symptom in a person who otherwise has minimal activity limitations.
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Visual Disturbances - The first symptom of MS for many people. Optic neuritis, neuromyelitis optica, blurred vision, poor contrast or colour vision, and pain on eye movement can be frightening. Eye twitches (nystagmus) or double vision (diplopia) may also occur and should be evaluated promptly.
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Bladder Problems - Bladder dysfunction, which occurs in at least 80% of people with MS, can usually be managed quite successfully with medications, fluid management, and intermittent self-cathetersation. People may experience incontinence or an increased frequency of going to the toilet​.
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Bowel Problems - Constipation is a particular concern among people with MS, as is loss of control of the bowels. Bowel issues can typically be managed through diet, adequate fluid intake, physical activity and medication.
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Speech Difficulties - Speech difficulties of some kind are quite common for people with MS. Speech difficulties can come and go throughout the day, perhaps lasting only a few minutes at a time, and may be a symptom that appears during a relapse. For most people, changes in speech are mild, and don't stop them from being understood. Swallowing weakness (dysphagia) and/or difficulty with speech/articulation (dysarthria) may also occur.
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Numbness or Tingling - Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.
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Walking Difficulties - Related to several factors including weakness, spasticity, loss of balance, sensory deficit and fatigue, and can be helped by physical therapy, assistive therapy and medications. People may experience a lack of coordination (ataxia).
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Foot Drop - Foot drop, or dropped foot, is a symptom of Multiple Sclerosis caused by weakness in the ankle or disruption in the nerve pathway between the legs and the brain. This disruption means it is difficult to lift the front of the foot to the correct angle during walking. As a result, the foot hangs down and may catch or drag along the ground and can cause trips and falls.
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Spasticity - Refers to feelings of stiffness and a wide range of involuntary muscle spasms; can occur in any limb, but it is much more common in the legs.
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Pain & Itching - Pain syndromes are common in MS. In one study, 55% of people with MS had "clinically significant pain" at some time, and almost half had chronic pain.
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Weakness - Weakness in MS, which results from deconditioning of unused muscles or damage to nerves that stimulate muscles, can be managed with rehabilitation strategies and the use of mobility aids and other assistive devices.
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Vertigo & Dizziness - People with MS may feel off balance or lightheaded, or — much less often — have the sensation that they or their surroundings are spinning (vertigo).
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Tremors - A tremor can be described as a rhythmic trembling or shaking movement that you cannot control voluntarily. Tremor might be so mild that no one else notices it, or it might be more pronounced, causing a drink to spill when a cup is full, for example, or affecting handwriting.
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MS Hug (Dysesthesia) - The MS hug, also known as banding or girdling, is a symptom of Multiple Sclerosis in which you feel chest pain, rib pain or a tight uncomfortable band around your chest. It can be felt anywhere between the neck and the waist and may feel so tight around the chest that it’s painful to breathe. For some people, it can be pressure on just one side of their body. Some people experience a symptom similar to the MS hug but in their hands or feet, where it feels as though you are constantly wearing gloves or boots. For others, the tight feeling is around the head. The feeling can range from annoying to very painful. The feeling is different for everyone and may be described as pressure, an ache, a tickle, a pain or a burning feeling. It may be sharp or dull and can be short or long lasting.
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Uhthoff's Phenomenon - Uhthoff's phenomenon or Uhthoff's sign is the temporary worsening of MS symptoms caused by an increase in temperature. It is usually applied to optic neuritis and other visual symptoms but can also refer to fatigue, pain, balance, weakness, bladder issues, cognitive or sensory symptoms.
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​Pseudobulbar Affect - Pseudobulbar affect (PBA) is a neurologic effect that occurs in 10 percent of people with MS, although some research suggests a much larger percentage. It is characterised by sudden, uncontrollable expressions of laughter or crying without an apparent trigger.
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Hearing Problems - Hearing problems aren't a common MS symptom. But people with MS can sometimes experience problems including tinnitus, increased sensitivity to sound and loss of hearing. A small number of people with MS have difficulties understanding spoken language. This is known as receptive aphasia. It’s a problem with language processing, not a change in hearing.
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Sexual Problems - Very common in the general population including people with MS. Sexual responses can be affected by damage in the central nervous system, as well by symptoms such as fatigue and spasticity, and by psychological factors.
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Cognitive Changes - Refers to a range of high-level brain functions affected in more than 50% of people with MS, including the ability to process incoming information, learn and remember new information, organize and problem-solve, focus attention and accurately perceive the environment. Memory loss and other brain-related problems (e.g. attention span, reaction time, spatial awareness abilities) can be common.
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Emotional Changes - Can be a reaction to the stresses of living with MS as well as the result of neurologic and immune changes. Anxiety, mood swings, irritability, and episodes of uncontrollable laughing and crying pose significant challenges for people with MS and their families.
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Depression - If you think you might be depressed, it's important to talk to your health care professional as soon as you can, so you can start to get help. Depression isn't something you can prevent, so you shouldn't feel embarrassed or ashamed of what you're going through.