Symptoms at the onset of Multiple Sclerosis

Multiple sclerosis (MS) may express itself in many different ways, when symptoms first appear in the early stage of the disease since it affects various parts of the brain. (See Multiple Sclerosis).

Typically the symptoms arrive suddenly and quickly during one day or several days. Most experience only one symptom but some have several symptoms simultaneously. The most common symptoms are:

• Sensory disturbance: Decreased tactile sense, tingling and numbness such as the feeling that for example one arm is asleep.
• Reduced force in one or more limbs.
• Visual impairment: Can be found in very varying degrees from slightly blurred vision to total blindness, often accompanied by pain behind the eye, especially when moving the eye.
• Double vision.

It is characteristic that these symptoms usually disappear entirely within days to weeks.

Disease progression symptoms in Multiple Sclerosis

Just as the disease might express itself very differently at the onset also the symptoms during the progression will vary widely from patient to patient, but the disease pattern becomes increasingly uniform over time. The following symptoms are frequently seen:

• Fatigue: It is a pronounced fatigue where neither rest nor sleep helps and for many this condition is debilitating in itself.
• Paralysis: This can affect both arms and legs and can involve one or all 4 limbs. Initially tiredness is experienced very quickly followed by a reduced force in the muscles leading to eventual total paralysis. In connection with the paralysis the muscles often become spastic with convulsive contractions called spastic paralysis.
• Impaired vision of varying severity: Possibly total blindness or just a blind spot in the visual field.
• Paralysis of eye muscles, thus the emergence of double vision since eye axis cannot be held parallel.
• Involuntary urination – incontinence.
• Recurring bladder inflammation.
• Problems with coordination of movements.
• Sensory disturbance: tingling, pricking or burning sensations, reduced tactile sense particularly for physical contact (touching), pain and temperature.
• Pain: This is often chronic pain with burning sensations, feeling of electric shocks in arms or legs. There may also be pain from muscle spasticity and in rare cases also facial pain (see Trigeminal neuralgia).
• Depression.
• Dementia: But usually first after many years of illness.
• Reactive indifference: It is not uncommon for patients with multiple sclerosis to have a peculiarly superficial and overly indifferent attitude towards their disease and condition.

Outlook and progression forms of Multiple Sclerosis

Just as the onset symptoms vary, also the individual experience of the early stages of the disease vary but with time the disease pattern becomes increasingly uniform. The pattern is often the following:

• Attack type cycles: There will be periodic relapse (attacks) of the above symptoms. There may be weeks to years between each attack and in the beginning the symptoms usually disappear during the period between relapses, but after a long illness some residual symptoms will remain after the attack is over.
• Secondary progressive cycle: This occurs after varying periods (typically 5-20 years) of attack type cycles heralding the presence of a slow but continuous deterioration.
• Primary progressive cycle: Very few patients never have attacks but from the very beginning experience a slow gradual reduction of various functions.
• Benign cycle: Approximately 1/5 of all multiple sclerosis patients never, or only very slowly, develop severe disability. Even after 15 years or so these patients only have moderate symptoms with almost normal everyday life activities including the ability to uphold their jobs.
• Malignant cycle: In rare cases the patients are victims of a very aggressive progression where severe disability develops in just a few months often ending fatally.

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