From The MS Information Sourcebook, produced by the National MS Society.
As a result of the inflammatory, demyelinating process in the central nervous system, people with MS can experience a wide variety of symptoms. The most common symptoms of MS include:
- Fatigue (also called MS lassitude to differentiate it from tiredness resulting from other causes)
- Problems with walking
- Bowel and or bladder disturbances
- Visual problems
- Changes in cognitive function, including problems with memory, attention, and problem-solving
- Abnormal sensations such as numbness or "pins and needles"
- Changes in sexual function
- Depression and/or mood swings
Less common symptoms include:
- Speech and swallowing problems
- Impaired hearing
All of these are considered primary symptoms of MS because they are a direct result of demyelination, the destruction of myelin—the fatty sheath that surrounds and insulates nerve fibers in the central nervous system—and of damage to the nerve fibers themselves. Demyelination and neuronal damage impair transmission of nerve impulses to muscles and other organs, resulting in impaired function. Many of these symptoms can be managed effectively with medication, rehabilitation, and other management strategies.
In addition to the primary symptoms caused by demyelination, there are other types of problems or complications that can occur as indirect results of the primary symptoms or the experience of having a chronic illness:
Secondary symptoms of MS are complications that can arise as a result of the primary symptoms. For example, bladder dysfunction can cause repeated urinary tract infections. Inactivity can result in loss of muscle tone and disuse weakness (not related to demyelination), poor postural alignment and trunk control, decreased bone density (and resulting increased risk of fracture), and shallow, inefficient breathing. Immobility can lead to pressure sores. While secondary symptoms can be treated, the optimal goal is to avoid them by treating the primary symptoms.
Tertiary symptoms of MS are the social, vocational and emotional complications associated with the primary and secondary symptoms. The diagnosis of a chronic illness can be damaging to self-esteem and self-image. A person who becomes unable to walk or drive may lose his or her livelihood. The strain of dealing with a chronic neurologic illness may disrupt personal relationships. People with MS frequently experience emotional changes as well, but it is important to note that mood swings and depression can occur as primary, secondary, or tertiary symptoms of the disease. Professional assistance from psychologists, social workers, physical and occupational therapists, and public health agencies is indicated for managing many of these psychosocial and vocational issues.
It is important to remember that not every person with MS experiences all of these symptoms. Some people may experience only one or two of them over the course of the disease, while others experience quite a few. Symptoms can come and go quite unpredictably, and no two people experience them in exactly the same way. Most of the symptoms of MS can be effectively managed, and complications avoided, with regular care by a neurologist and allied health professionals.
Clinical Bulletin for Healthcare Professionals
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—Ch. 4 Managing the Symptoms of Progressive Multiple Sclerosis
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—Ch. 3 Treatment
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