Multiple Sclerosis

Multiple sclerosis (MS) can cause a wide range of symptoms and can affect any part of the body. Each person with the condition is affected differently.

The symptoms are unpredictable. Some people's symptoms develop and worsen steadily over time, while for others they come and go.

Periods when symptoms get worse are known as "relapses". Periods when symptoms improve or disappear are known as "remissions".

Some of the most common symptoms include:

• fatigue
• vision problems
• numbness and tingling
• muscle spasms, stiffness and weakness
• mobility problems
• pain
• problems with thinking, learning and planning
• depression and anxiety
• sexual problems
• bladder problems
• bowel problems
• speech and swallowing difficulties

Most people with MS only have a few of these symptoms.

See your GP if you're worried you might have early signs of MS.The symptoms can be similar to severalother conditions, so they're not necessarily caused by MS.

You may experience:

• some temporary Visual impairment in the affected eye, usually lasting for days to weeks
• colour blindness
• eye pain, which is usually worse when moving the eye
• flashes of light when moving the eye

Other problems that can occur in the eyes include:

• double vision
• involuntary eye movements, which can make it seem as though stationary objects are jumping around

Occasionally, both of your eyes may be affected.

Abnormal sensations

Abnormal sensations can be a common initial symptom of MS.

This often takes the form of numbness or tingling in different parts of your body, such as the arms, legs or trunk, which typically spreads out over a few days.

Muscle spasms, stiffness and weakness

MScan cause yourmuscles to:

• contract tightly and painfully (spasm)
• become stiff and resistant to movement (spasticity)
• feel weak

Mobility problems

MS can make walking and moving around difficult, particularly if you also have muscle weakness and spasticity (see above). You may experience:

• clumsiness
• difficulty with balance and co-ordination ( ataxia )
• shaking of the limbs ( tremor )
• dizziness and vertigo , whichcan makeit feel asthougheverything around you isspinning

Pain

Some people with MS experience pain, which can take two forms:

• Pain caused by MS itself (neuropathic pain) this is pain caused by damage to the nervous system. This may include stabbing pains in the face and a variety of sensations in the trunk and limbs, including feelings of burning, pins and needles, hugging or squeezing. Muscle spasms can sometimes be painful.
• Musculoskeletal pain back, neck and joint pain can be indirectly caused by MS, particularly for people who have problems walking or moving around that puts pressure on their lower back or hips.

Problems with thinking, learning and planning

Some people with MS have problems with thinking, learning and planning known as cognitive dysfunction. This can include:

• problems learning and remembering new things long-term memory is usually unaffected
• slowness in processing lots of information or multi-tasking
• a shortened attention span
• getting stuck on words
• problems with understanding and processing visual information, such as reading a map
• difficulty with planning and problem solving people often report that they know what they want to do, but can't grasp how to do it
• problems with reasoning, such as mathematical laws or solving puzzles

However, many of these problems aren't specific to MS and can be caused by a wide range of other conditions, including depression and anxiety, or even some medications.

Mental health issues

Manypeople with MS experience periods of depression . It's unclear whether this is directly caused by MS, or is due to the stress of having to live with a long-term condition, or both.

Anxiety can also be a problem for people with MS, possibly due to the unpredictable nature of the condition.

In rare cases, people with MS can experience rapid and severe mood swings, suddenly bursting into tears, laughing or shouting angrily for no apparent reason.

Sexual problems

MS can have an effect on sexual function.

Men with MS often find it hard to obtain or maintain an erection ( erectile dysfunction ). They may also find it takes a lot longer to ejaculate when having sex or masturbating, and may even lose the ability to ejaculate altogether.

For women, problems include difficulty reaching orgasm, as well as decreased vaginal lubrication and sensation.

Both men and women with MS may find they are less interested in sex than they were before. This could be directly related to MS, or it could be the result of living with the condition.

Bladder problems

Bladder problems are common in MS. They may include:

• having to pee more frequently
• having a sudden, urgent need to pee, which can lead to unintentionally passing urine ( urge incontinence )
• difficulty emptying the bladder completely
• having to get up frequently during the night to pee
• recurrent urinary tract infections

These problems can also have a range of causes other than MS.

Bowel problems

Many people with MS also have problems with their bowel function.

Constipation is the most common problem.You may find passing stools difficult and pass them much less frequently than normal.

Bowel incontinence is less common, but is often linked to constipation. If a stool becomes stuck, it can irritate the wall of the bowel, causing it to produce more fluid and mucus that can leak out ofyour bottom.

Again, some of these problems aren't specific to MS and can even be the result of medications, such as medicines prescribed for pain.

Speech and swallowing difficulties

Some people with MS experience difficulty chewing orswallowing ( dysphagia ) at some point.

Speech may also become slurred, or difficult to understand ( dysarthria ).