Multiple Sclerosis
Signs & Symptoms
Symptoms vary from person to person. No two people have the same symptoms.
A patient's medical history including their present and past symptoms
are considered by a physician before carrying out a series of tests to
check for signs to correlate and explain the symptoms or point to disease
activity. Signs of MS are indications of the disease that are objectively
determined by a physician.
A physical examination often includes the following:
-
Eye examination – This
may reveal damage to the optic nerve.
-
Muscle Strength – This
can be done gently but firmly pulling and pushing a person’s
arms and legs.
-
Coordination – This is
carried out by asking the patient to bring the tip of the
index finger to the nose rapidly with open eyes and closed
eyes (finger-to-nose test).
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Sensation – Body surface
sensation is tested with a safety pin, feather or a light
touch.
-
Vibratory Sense – A vibrating
tuning fork is placed at a joint or bone so that a person
experiences a buzz-like sensation.
-
Reflex – Reflexes are
examined using fingers or a small rubber mallet.
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Common signs observed by a doctor during physical
examination include:
- Altered eye movements and abnormal responses of
the pupils
- Subtle changes in speech patterns
- Altered reflex responses
- Impaired coordination
- Sensory disturbances
- Evidence of spasticity and/or weakness in the
arms or legs (6).
General symptoms of MS are fatigue, weakness,
spasticity, balance problems, bladder and bowel problems,
numbness, vision loss, tremors and depression. Most of
the patients experience episodic patterns of attacks and
remission through out the course of disease. Symptoms
define the clinical picture of MS and are a result of
nerve lesions causing disturbance in electrical
conduction in the Central Nervous System (CNS). Symptoms
can determine the location of lesions such as an optic
nerve lesion causes blurred vision, brain stem lesion may
cause dizziness or double vision and a spinal cord lesion
may cause coordination or balance problems.
Following are some of the lesion locations and the
corresponding signs or symptoms that appear in a patient:
Lesion
Location
|
Signs
or Symptoms
|
Cerebrum &
Cerebellum
|
Balance problems,
speech problems, poor coordination and tremers |
Motor Nerve
Tracts
|
Muscle weakness,
spasticity paralysis, vision problems, bladder
and bowel problems. |
Sensory Nerve
Tract
|
Altered sensation,
numbness, prickling and burning sensation |
Symptoms in patients suffering from MS
include:
-
Fatigue: About 78% of MS patients suffer
from fatigue. The fatigue is usually late in the afternoon and often
subsides in early evening.
-
Numbness, Tingling and Burning sensation:
The earliest symptoms of MS are sensory symptoms occurring in 55%
patients. Patients experience tingling, crawling and a feeling of
swelling or numbness in the trunk.
-
Tremors: About 50% patients suffer
from shaking or trembling of the limbs or occasionally the head (extreme
ataxia). This symptom may lead to impaired mobility and is often associated
with difficulty in balancing and coordination.
-
Depression: Onset of the disease often
leads to depression.
-
Spasticity: In about 41% of cases,
spasticity occurs with initial attack and in approximately 62% cases
spasticity occurs with a progressive disease. Spasticity occurs when
opposing groups of muscles contract and relax at the same time.
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Bladder: Increased frequency of urination,
urgency, dribbling, hesitancy and incontinence.
-
Bowel: Constipation, diarrhea and incontinence.
Dysfunction occurs in almost two thirds of patients during the course
of disease.
-
Vision loss: Usually starts with a
blurred vision followed by loss of vision from 20/20 to 20/30 to 20/40.
-
Cognitive and Emotional Dysfunction:
About 50% of patients with MS suffer from cognitive and emotional
dysfunction involving memory, reasoning, verbal fluency and speed
of information processing.
-
Sexual Difficulties: After the onset
of disease, more than 90% males and more than 70% females report a
change in their sexual life. Some of the problems include decreased
sexual drive, impaired sensation, diminished orgasmic response and
loss of sexual interest (7).
Article by Kona Vishnu, MS
Medical Writer,
OmniMedicalSearch.com
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