Multiple Sclerosis (MS) Symptoms: Understanding the Signs
Multiple sclerosis is a chronic inflammatory demyelinating disease of the CNS. Symptoms vary by lesion location and disease course (RRMS, SPMS, PPMS).
Common Symptoms
- Fatigue (80%): Overwhelming, not relieved by rest; worsens with heat.
- Sensory: Numbness, tingling, paresthesias, Lhermitte's sign (neck flexion → electric shock down spine).
- Motor: Weakness, spasticity, hyperreflexia, clonus, Babinski.
- Visual: Optic neuritis (painful vision loss, color desaturation), diplopia (INO), nystagmus.
- Brainstem/Cerebellar: Dysarthria, ataxia, tremor, vertigo, nausea.
- Bladder/Bowel: Urgency, frequency, hesitancy, retention, constipation, incontinence.
- Cognitive (40–65%): Processing speed, memory, executive function, attention.
- Mood: Depression (50% lifetime), anxiety, pseudobulbar affect.
- Pain: Neuropathic (trigeminal neuralgia, dysesthesias), musculoskeletal.
- Uhthoff's phenomenon: Symptom worsening with heat.
Diagnosis
McDonald criteria: dissemination in space (MRI lesions) + time (new lesions/CSF oligoclonal bands).
Key Takeaway
MS symptoms are diverse and fluctuating. Early diagnosis and disease-modifying therapy (DMT) reduce relapse rate and disability accumulation.
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