One of the most challenging aspects of living with multiple sclerosis (MS) is managing disease symptoms. MS is an autoimmune disease that attacks the central nervous system (CNS), which is made up of the brain and spinal cord. The autoimmune attacks cause lesions that damage the nerves and the myelin, a fatty substance that insulates the nerves. When myelin is destroyed, nerve signals become less effective and the brain cannot communicate properly. Because the brain directly or indirectly controls most bodily systems, MS symptoms can affect the function of various body parts.

Symptoms of MS vary in each individual and across different types of MS. In people with relapsing-remitting MS, symptoms may decrease or disappear during periods of remission, only to reappear or worsen with subsequent disease flare-ups. In contrast, people with primary progressive MS experience gradual worsening of symptoms over time.

Fortunately, various therapies can help to effectively manage MS symptoms.

Types of MS Symptoms

MS causes neurological symptoms that can manifest in several different ways. MS symptoms may appear in different combinations, depending on which parts of the CNS are damaged. Most common symptoms fall within the broad categories of motor symptoms, cognitive symptoms, and symptoms that affect other aspects of the body.

Motor Symptoms

Motor problems are common in people with MS and can severely affect mobility and quality of life. Difficulty with walking (gait) is often affected. Other common symptoms of MS include muscle weakness, slowness, muscle spasms, and balance problems. These issues contribute to gait difficulties and raise the risk for falls and injury. Doctors use the word “ataxia,” meaning loss of full control over bodily movements, to describe these changes.

Between 25 percent and 40 percent of people with MS develop speech problems. Speech issues often develop later in the disease course and worsen with fatigue. Common speech problems in MS include dysarthria (slurring) and dysphonia (low speaking volume) as well as stuttering. Similarly, many people with MS may develop dysphagia, or trouble swallowing. Dysphagia raises the risk of choking or inhaling food or drink, which can lead to lung infections.

Less common motor symptoms may include breathing problems — if MS affects muscles or nerves in the chest — and tremors.

Cognitive Symptoms

More than 50 percent of people with MS experience cognitive difficulties. Cognitive changes, often referred to collectively as “cog fog” or brain fog, can include problems with:

• Memory
• Focus
• Paying attention
• Processing information
• Forgetting or confusing words
• Learning and remembering new things
• Organizing
• Getting lost in familiar places

General Symptoms

Fatigue is one of the most common MS symptoms. About 80 percent of people with MS experience fatigue severe enough to have an impact on their daily activities.

MS often affects the optic nerves, causing inflammation known as optic neuritis. Optic neuritis can cause vision problems, including:

• Blurred vision
• Blind spots
• Double vision
• Pain or difficulty with eye movement
• Loss of vision in one eye

Changes in physical sensation such as numbness, tingling, or pins-and-needles prickling sensation (referred to as paresthesia) are very common in people with MS. Paresthesia may occur in the face, body, or arms and legs. The sensation may be mild enough to be ignored or so severe that it becomes difficult to walk, eat, or write, depending on which body part is affected.

Dizziness and vertigo are common in those with MS. These sensations are sometimes described as feeling light-headed, or that the room seems to be spinning.

MS can cause emotional changes such as mood swings, irritability, and sudden bouts of intense laughter or crying (known as pseudobulbar affect) that do not reflect the person’s actual feelings. People with MS often experience depression.

It is very common for those with MS to experience significant neuropathic pain, either temporarily or on a chronic basis.

As many as 80 percent of people with MS experience bladder dysfunction, which can lead to incontinence, urinary tract infections, and kidney problems. Bowel issues, especially constipation, are common in those with MS.

MS can affect sexual function, causing problems like erectile dysfunction in men. Women can experience loss of sexual sensation, painfully heightened sensation, or vaginal dryness as a result of MS.

Less commonly, MS can cause seizures, itching, and loss of hearing.

What Are the Early Signs of MS?

MS begins differently for each person. For many people, vision changes and paresthesia are among the first symptoms to be noticed. Other early symptoms of MS include motor issues or bowel problems such as constipation and diarrhea. Some people may experience several symptoms at the same time.

Do Men and Women Experience Different MS Symptoms?

Women are about three times as likely as men to develop MS, and men and women may experience MS in different ways. Studies have shown that men are more likely to have a progressive course of disease and to accumulate disability more quickly than women. Relapses among men are also more likely to affect motor function than sensory function. In contrast, women with MS going through menopause are more likely to have sleep disturbances than men. For pregnant women with MS, symptoms may improve during pregnancy but worsen again following delivery.

MS Condition Guide

• Multiple Sclerosis (MS) — An Overview
• Multiple Sclerosis Types
• What Causes MS?
• Treatments for Multiple Sclerosis
• Multiple Sclerosis — The Path to Diagnosis