The symptoms of MS are different in each person. They may be mild, or they may be debilitating. Symptoms may be constant, or they may come and go. There are four typical patterns of progression of the disease.
The progression of MS typically follows one of these patterns.
In this pattern of progression, periods of severe symptoms (exacerbations) are followed by periods of recovery (remissions). Remissions may last months or even years. Exacerbations may occur with or without a trigger such as infection or stress.
Primary Progressive Pattern
This form of MS progresses gradually with no remissions and no exacerbations. There may be periods when symptoms remain unchanged temporarily.
Secondary Progressive Pattern
After an initial period of remissions and relapses, this form of MS progresses gradually.
Progressive Relapsing Pattern
This form of MS is rare. The pattern is gradual progression of the disease with periods of sudden relapse.
The most common first symptoms of MS are:
- numbness and tingling in one or more extremities, in the trunk, or on one side of the face
- weakness, tremor, or clumsiness in a leg or hand
- partial loss of vision, double vision, eye pain, or areas of visual alteration
Other common symptoms include the following.
Fatigue is the most common and often the most disabling symptom of MS. It may occur in several different forms:
- activity-related fatigue
- fatigue due to deconditioning (not being in good shape)
- lassitude—also known as “MS fatigue”
The fatigue associated with MS is often worse in the late afternoon.
Bladder and Bowel Dysfunction
Bladder and bowel dysfunction can be ongoing or intermittent problems in MS. Bladder frequency, waking up at night to void, and bladder accidents can be symptoms of this problem. Bowel dysfunction can result in constipation, bowel urgency, loss of control, and irregular bowel habits.
Weakness in multiple sclerosis can be related to an exacerbation or a flare-up or can be an ongoing problem.
Cognitive changes related to MS can be obvious or very subtle. They may include memory loss, poor judgment, decreased attention span, and difficulty reasoning and solving problems.
Acute and Chronic Pain
Like symptoms of weakness, pain in MS can be acute or chronic. Burning sensations and electric shock–like pain can occur spontaneously or in response to being touched.
MS spasticity can affect your mobility and comfort. Spasticity can be defined as spasms or stiffness and may involve pain and discomfort.
Both clinical depression and a similar, less severe emotional distress are common in people with MS. About 50 percent of patients experience depression at some time during their illness (Siegert & Abernethy, 2005).