Brain & Nervous System Multiple Sclerosis Symptoms Multiple Sclerosis Guide Multiple Sclerosis Guide Symptoms Causes Diagnosis Treatment Living With Symptoms of Multiple Sclerosis By Julie Stachowiak, PhD facebook Julie Stachowiak, PhD, is the author of the Multiple Sclerosis Manifesto, the winner of the 2009 ForeWord Book of the Year Award, Health Category. Learn about our editorial process Julie Stachowiak, PhD Medically reviewed by Medically reviewed by Claudia Chaves, MD on April 19, 2019 Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology. Learn about our Medical Review Board Claudia Chaves, MD Updated on May 12, 2020 Print Table of Contents View All Frequent Symptoms Rare Symptoms Complications When to See a Doctor Next in Multiple Sclerosis Guide Causes and Risk Factors of Multiple Sclerosis Multiple sclerosis (MS) is a disease with multiple symptoms, which range from fatigue to muscle weakness, vision issues to cognitive dysfunction, and beyond. In fact, there are so many possible symptoms of MS that it's rare for two people with this disease to have the exact same ones. On top of that, in most cases, the symptoms of MS come and go (relapse and remit), and their severity can vary greatly. The reason for all of this stems from the nature of the autoimmune disease itself and depends on the location and extent of the damage to your myelin—the protective layer that allows your nerves to transmit the electrical impulses tied to movement, breathing, thinking, and more. Verywell / Emily Roberts Frequent Symptoms In spite of each case of MS being unique, a particular set of symptoms is really common. It includes: FatigueMuscle-related symptomsBowel and bladder symptomsCognitive dysfunctionDepressionSexual dysfunctionVision problemsVertigoPain and other sensory symptoms Fatigue This fatigue goes beyond normal tiredness. It's physical and mental exhaustion that isn't relieved by sleep or rest. Fatigue is the most debilitating aspect of MS for many people. It's a complex problem, though. Fatigue can result from any combination of the following factors: MS itselfMedications for MS, both disease-modifying therapies and drugs for managing symptomsSymptoms that keep you awake or wake you up frequently, such as pain, heat sensitivity, and an overactive bladderSleep disorders that are common in people with MS, including insomnia, sleep apnea, and restless legs syndromeDepression 3:01 3 Women Share Their Experiences Managing MS in the Heat Effective treatment for your fatigue relies on getting to the bottom of what's causing it, so it's important to work with your doctor to find out. Muscle-Related Symptoms When communication to the nerves controlling your muscles is impaired, your muscles can behave in abnormal ways. Muscle-related symptoms of MS often include: Weakness severe enough to make even simple tasks, like walking or brushing your teeth, difficult or impossibleSpasticity: Involuntary muscle tightness ranging from mild stiffness to intensely painful cramps that make it hard to moveTremor: Shaking that's out of control In some, these symptoms are bad enough to require an assistive device, like a cane or wheelchair, or even keep them in bed. Mobility Assistive Devices for MS Bowel and Bladder Symptoms As many as 80% of people with MS have bowel and/or bladder problems. Common bladder symptoms include: Frequent urinationUrgency while urinatingHesitancy when urinatingInability to control urinationFrequent urinary tract infections, which can trigger the worsening of MS symptoms Bowel problems may result from damage to the myelin around nerves that transmit signals from the brain to the bowels. Constipation is the most common one, but lack of bowel control can also be a problem. Some MS medications may cause constipation as a side effect, so be sure to speak to your doctor about your current treatment if this symptom is a problem for you. Cognitive Dysfunction Around 50% of people with MS have some form of cognitive dysfunction. These can include: Short-term memory impairment (e.g., not remembering why you walked into a room)Difficulty paying attention or concentratingWord-finding problemsIssues processing sensory information While many people experience these things every now and then, they are far more pervasive problems in people with MS. Depression Depression is common in people with chronic disease. That's understandable, with the added stress and challenges associated with long-term illness. It's even more common in people with MS, though. It's believed that demyelination in the brain may play an added role in causing depression in those with the disease. On top of that, some MS drugs may cause or contribute to depression, especially interferon drugs such as Avonex, Betaseron, or Rebif. Clinical depression is more than just regular sadness. Symptoms may include: Losing interest in things you used to enjoyBeing unable to experience pleasureLoss of appetiteLoss of interest in sexLow energyUnexplained aches and painsThoughts of suicide If you or someone in your life is thinking about suicide or engaging in suicidal behavior, be sure to get medical help right away. Suicide Warning Signs and Risk Factors Sexual Dysfunction When your desire or ability to have sex is impaired, it can be damaging psychologically and impact your intimate relationships. Related issues common in MS include: Difficulty maintaining an erectionInability to achieve orgasmLoss of desireReduced sensation or unpleasant sensation in the vaginal areaVaginal dryness Help is available for these problems. It can be difficult to bring them up to a doctor, or even to your partner(s), but talking about it is the first step to getting better. Vision Problems Damage to the optic nerve due to inflammation (optic neuritis) is common in MS, and that leads to myriad vision-related problems. It is especially common in the early stages of the disease, and its symptoms may be among the first you experience with MS. It can affect one or both eyes and may include: A dull ache behind your eyePain when moving your eyeVision impairment or lossWashing out or loss of color visionBlind spotsFlashing or flickering lights Another vision problem, which is often an early sign of MS, is mismatched pupils. This is called Marcus Gunn pupil or the relative afferent pupillary defect (RAPD). Basically, one pupil doesn't constrict (get smaller) like it should when light hits your eyes. Pupil Size As a Sign of MS Vertigo Vertigo, or dizziness, is the sensation that you are spinning. It can result from MS-related damage to the brainstem, which is a stalk at the base of your skull that connects the brain and spinal cord. It can also be caused by a lesion in the cerebellum. It may also be associated with an abnormal eye movement called nystagmus and occur alongside gait imbalance, double vision, or slurred speech. Some MS medications may also cause vertigo. Pain and Other Sensory Symptoms Not everyone with MS has pain, but many do—and not just one type. Abnormal nerve sensations can include electrical nerve zings, numbness and tingling, prickling, stabbing, tearing, or feelings of pressure. These sensations can happen anywhere in the body at any time and range from annoying to drop-you-to-your knees painful. MS involves a couple of distinctive pains that are highly indicative of the disease. They are: Lhermitte's sign, which is a sudden electric zap down the spine that happens when you touch your chin to your chestThe MS hug, which is a tightness that's usually felt around the chest or stomach What Nerve Pain Feels Like Nerve pain, also called neuropathic pain, is hard to imagine if you've never felt it. It can be compared to hitting your funny bone, or the pin-prick sensation of blood rushing back into a foot that's fallen asleep to the point that it's numb. Rare Symptoms Some people with MS aren't aware that these uncommon symptoms are related to the disease. Rare symptoms include: Trigeminal neuralgia (tic douloureux): Shock-like or burning pains in the faceGlossopharyngeal neuralgia: Pain in the tongue, throat, ear, or tonsilsParoxysmal symptoms: Momentary spasms in the limbs and sometimes in the muscles associated with speech or swallowing; sometimes mistaken for seizuresPseudobulbar affect: Uncontrollable laughing or crying that's not related to feelings or situations in which that response is normalPruritis: A neurologically caused "itch" that doesn't respond to scratching or topical treatmentsSwallowing problems (dysphasia): This can cause choking or coughing while you eat or drink.Breathing difficulty due to muscle weaknessHearing loss: About 6% of people with MS experience temporary lessening or loss of hearing; actual deafness is exceedingly rare.Seizures: These can affect between 2 and 5% of people with MS Complications Complications aren't true symptoms, but things that can happen as a result of them. Not everyone will experience them, and they vary greatly in those who do. Some possible complications of MS include: Aspiration pneumonia: A lung infection caused by inhaling food particles due to dysphagia or difficulties swallowingMalnutrition and dehydration: Also due to dysphagiaPressure sores: Due to lack of mobilityVenous thromboembolism: Blockage to blood vessels due to blood clots; may be due to lack of mobility, spasticity, or as a side effect of steroid medications When to See a Doctor If you have symptoms that could indicate MS, and especially if they come and go, be sure to talk to your doctor about it. Early MS diagnosis and treatment have long-term benefits, so don't hesitate or wait to bring up what you're experiencing. After your diagnosis, it's important to let your doctor know about any changes or new symptoms you experience. Remember that just because something can result from MS doesn't mean that it does for sure. You don't want to dismiss something as "just another MS symptom" only to have it be something else that needs prompt diagnosis and treatment. A Word From Verywell Looking over these lists can be overwhelming. Keep in mind that you probably won't experience most of the potential symptoms. With proper treatment and management, you may be able to avoid the bulk of them. Causes and Risk Factors of Multiple Sclerosis Was this page helpful? Thanks for your feedback! Get tips and advice on how you can live a full and happy life with MS. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. National Multiple Sclerosis Society. MS Symptoms. Newsome SD, Aliotta PJ, Bainbridge J, et al. A Framework of Care in Multiple Sclerosis, Part 2: Symptomatic Care and Beyond. Int J MS Care. 2017;19(1):42-56. doi:10.7224/1537-2073.2016-062 National Multiple Sclerosis Society. Bladder Problems. Kisic-tepavcevic D, Pekmezovic T, Trajkovic G, et al. Sexual dysfunction in multiple sclerosis: A 6-year follow-up study. J Neurol Sci. 2015;358(1-2):317-23. doi:10.1016/j.jns.2015.09.023 Kale N. Optic neuritis as an early sign of multiple sclerosis. Eye Brain. 2016;8:195-202. doi:10.2147/EB.S54131 Blazek P, Davis S, Greenberg B, et al. Objective characterization of the relative afferent pupillary defect in MS. 2012 Dec 15;323(1-2):193-200. doi:10.1016/j.jns.2012.09.015 Serra A, Chisari CG, Matta M. Eye Movement Abnormalities in Multiple Sclerosis: Pathogenesis, Modeling, and Treatment. Front Neurol. 2018;9:31. doi:10.3389/fneur.2018.00031 Khare S, Seth D. Lhermitte's Sign: The Current Status. Ann Indian Acad Neurol. 2015;18(2):154-6. doi:10.4103/0972-2327.150622 Motamed MR, Fereshtehnejad SM, Abbasi M, Sanei M, Abbaslou M, Meysami S. X-ray radiation and the risk of multiple sclerosis: Do the site and dose of exposure matter?. Med J Islam Repub Iran. 2014;28:145. Tekin M, Acar GO, Cam OH, Hanege FM. Sudden sensorineural hearing loss in a multiple sclerosis case. North Clin Istanb. 2014;1(2):109-113. doi:10.14744/nci.2014.35744 National Multiple Sclerosis Society. Seizures. Additional Reading Birnbaum, M.D. George. (2013). Multiple Sclerosis: Clinician’s Guide to Diagnosis and Treatment, 2nd Edition. New York, New York. Oxford University Press. Ziemssen T. Symptom Management in Patients With Multiple Sclerosis. J Neurol Sci. 2011 Dec;311 Suppl 1:S48-52. doi:10.1016/S0022-510X(11)70009-0