Multiple sclerosis is a little sneaky at the onset.
It’s easy to shrug off feeling exhausted every day because you’re working too many hours or staying up too late watching Netflix. Weakness in your hands might make you think you’ve just spent too many hours scrolling your iPhone for new posts to retweet. That’s probably why many patients with initial symptoms of multiple sclerosis (MS) may head to their doctor with no expectation of what they’re about to hear.
“They’re thinking it could be an infection or some other mild medical complaint,” says Neurologist Michelle Fabian, MD, of the Mount Sinai Hospital in New York City. “Then a diagnosis of MS takes them by surprise.”
It can be even more surprising if you’re not totally sure what MS is. Multiple sclerosis is an autoimmune disease that attacks the central nervous system. To put it simply, MS damages the brain’s ability to initiate and coordinate movements. (Learn more about how MS affects the body here.)
What are the symptoms of multiple sclerosis?
To make the diagnosis even more complex, each MS patient may present slightly different symptoms due to the way their lesions have formed, according to Dr. Fabian. Not surprisingly, these varying symptoms can be misdiagnosed as everything from carpal tunnel or vitamin B12 deficiency in the beginning (just to name a couple); and a patient may have MS for years before being diagnosed with it.
Even though many of these symptoms are not exclusive to MS, here are the common MS symptoms to be aware of.
Fatigue, which affects about 80 percent of patients
Difficulty walking due to numbness or loss of balance
Numbness in the face, arms, and legs
Vision problems such as double vision or blurriness in one or both eyes
Muscle spasms or stiffness, especially in the legs
Dizziness or loss of balance
Bladder and bowel dysfunction
Weakness in the arms and legs, making everyday movements like walking up stairs or brushing their hair more difficult
Cognitive fatigue, affecting the patient’s ability to focus, problem solve, or learn new information
Thankfully, an MS diagnosis isn’t the same as it used to be 30 years ago when treatment options were far more limited and less effective. Newer treatment for MS can address symptoms and reduce or prevent the progression of the disease. Find out how comprehensive treatment for multiple sclerosis has changed patients’ lives here.
Dr. Fabian is the assistant professor of neurology at The Mount Sinai Hospital in New York City.
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Every MS patient, because of the way
that their MS lesions are formed,
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they have a different and unique patterns
of symptoms compared to the next patient
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Most people I find actually don't think
of MS when they have their symptom and
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they go into the primary care doctor.
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They're thinking it could be that
they have an infection or some other
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mild medical complaint, and then
a diagnosis of MS takes them by surprise.
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MS can be misdiagnosed, especially in
the beginning when symptoms are mild.
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Patient may come in with something
like a numbness in the hand and
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a doctor chalk it up to carpal tunnel
syndrome or something similar.
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I've seen patients who, couple days after
they have a symptom, they're in my office,
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and some patients it actually takes
some years before they get diagnosed.
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So if we think about
the parts of the body,
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MS can affect most of them,
the way the nervous system does.
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So we can think about the vision.
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People can have blurry vision
in one eye or the other.
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They also can have double vision.
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That's another symptom people can have.
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They can have numbness.
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They can have numbness on their face,
they can have numbness on their body.
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They can have weakness in their body.
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They can have dizziness.
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And they can have issues with
their bowel and bladder.
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So that's something that
not everybody has, but
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that sometimes will come
along with a diagnosis of MS.
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Weakness is a term that patients
sometimes will use in different ways.
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And so sometimes when they use that,
they actually mean that they're numb.
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Their arm doesn't feel the same,
and it's because of numbness, but
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sometimes it's a decrease in strength.
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So if somebody has weakness in their arms,
what they'll usually tell me is that
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they have trouble using their hands
like typing, texting, buttoning,
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all that stuff will be more difficult.
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If the weakness is more kind of in
their upper arm, they might have
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trouble combing their hair,
blow drying their hair, things like that.
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If the weaknesses in their legs,
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they will typically tell me
they have trouble walking.
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MS50 is a very common symptom of MS.
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It occurs in over 80% of people with MS.
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And it can be something that
is very frustrating for
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patients, if that's something
that you can see on a patient.
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The way that you might be able to test
their senastion, or test their strength.
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Can't really test somebody's
fatigue level, and so hard for
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people to express to people around them
how the fatigue is impacting their life.
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The other thing would
be cognative symptoms,
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which don't occur in
everybody with a diagnoisis.
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They do occur in 35 to 65% of people.
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That can manifest in
a lot of different ways.
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But it can just be people who feel like
either their memory is a bit decreased, or
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there's a speed of learning things and
processing things is a bit slower.
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And so those are things, also, that
are important to talk to the doctor about.
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MS symptoms. New York, NY: National Multiple Sclerosis Society. (Accessed on April 13, 2021 at https://www.nationalmssociety.org/Symptoms-Diagnosis/MS-Symptoms.)
Patient education: multiple sclerosis in adults (the basics). Waltham, MA: UpToDate, 2021. (Accessed on April 13, 2021 at https://www.uptodate.com/contents/multiple-sclerosis-in-adults-the-basics.)
What is multiple sclerosis? New York, NY: Mount Sinai Hospital. (Accessed on April 13, 2021 at http://www.mountsinai.org/patient-care/service-areas/neurology/areas-of-care/corinne-goldsmith-dickinson-center-for-ms/symptoms-and-treatment.)