Symptoms
The symptoms of multiple sclerosis are many, and they affect each person differently. Symptoms vary depending on how much damage has occurred to the nerves and in which part of the central nervous system the damage occurs.
Some of the most common symptoms of multiple sclerosis are:
Visual problems
Visual problems are often among the first symptoms of multiple sclerosis. They include: inflammation or swelling of the optic nerve (optic neuritis), which can result in some loss of vision and pain behind one eye; pain behind both eyes; double vision; difficultly focussing; and colour blindness.
Muscle spasms and spasticity
Tight and painful muscle contractions (spasms) and/or stiffness and resistance to movement (spasticity) may occur as a result of damage to the nerve fibres that control the muscles.
Pain
Multiple sclerosis may be associated with two types of pain: neuropathic pain, which is caused by damage to the nerve fibres and typically results in stabbing sensations, skin sensitivity or burning sensations; and musculoskeletal pain, which is caused by pressure on muscles and joints from muscle spasms and spasticity.
Disturbed movement and balance
Coordination and balance may be affected, which can cause problems moving and walking. Muscle spasms and spasticity can cause further difficulties. Tremors or dizziness may also affect some people.
Cognitive difficulties
Mental processes may be affected resulting in difficulties in thought, memory, speech and concentration.
Emotional problems
Both depression and anxiety are more common in people with multiple sclerosis. Some people may find that they laugh or cry for no apparent reason.
Tiredness
Extreme tiredness is a common symptom.
Bladder problems
The bladder, which stores urine, is controlled by the nervous system . Multiple sclerosis may therefore affect bladder function. Some people may find that they need to urinate more frequently or urgently, whereas others may experience difficulty emptying the bladder or a feeling of incomplete emptying. The most severe bladder problems may result in occasional urinary incontinence.
Bowel problems
Nerve endings in the rectum help to alert people of the need to pass a stool when it enters the rectum. In people with multiple sclerosis, this message may become lost or incomplete increasing the risk of constipation, faecal incontinence or a combination of both. Drugs commonly prescribed for multiple sclerosis can also increase the likelihood of constipation.
Erectile dysfunction
Men with multiple sclerosis may experience erectile dysfunction. This can be caused by a combination of factors, including neurological dysfunction, psychological factors, side effects of medication or typical multiple sclerosis symptoms such as tiredness or bladder problems.
It is unlikely that a person with multiple sclerosis will experience all of these symptoms as each person is affected differently.
Causes
The cause of multiple sclerosis is not known for sure, although it is thought to be a combination of genetic and environmental factors. It is an autoimmune condition in which the body mistakes the myelin on nerve fibres for something foreign and attacks it. The reason for this response has not been determined.
There are four types of multiple sclerosis characterised by the pattern in which the symptoms occur. These are: - benign
- relapsing remitting
- secondary progressive
- primary progressive
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