Multiple Sclerosis
Symptoms of MS
Many MS symptoms are related and interdependent. One
untreated symptom may aggravate a host of additional
symptoms and strongly impact a patient’s quality
of life. For example, a fatigued patient may be more
susceptible to depression. Or a fatigued patient may
decrease his or her frequency of exercise, which in
turn may lead to increased spasticity and constipation.
Some of the more common MS symptoms include:
Fatigue
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Fatigue is the most common
symptom of MS, occurring in more than 75% of patients.
In 30% of patients, fatigue occurs before other
MS symptoms. |
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Generally occurs
daily and worsens as the day progresses |
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Typically more
severe than normal fatigue, occurs early in the
morning and comes on more easily and suddenly |
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Often described
as a feeling of extreme tiredness, fogginess and
lack of energy |
Bladder and bowel dysfunction
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Bladder
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Approximately 80% to
96% of patients with MS experience bladder
symptoms. These symptoms include: increased
frequency, urgency hesitancy, dribbling, and
incontinence. |
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Treatments
include consultation with a neuro-urologist,
diagnosis and treatment of urinary tract infections,
kegel exercises, incontinence pads, bladder
control medications or catheters. |
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Bowel
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35%-45%
of MS patients experience constipation. Causes
of constipation may vary from person to person
including MS-related neurological damage,
not drinking enough water (to avoid bladder
difficulties) and limited physical activity
due to weakness, fatigue, and spasticity. |
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Treatments
for constipation may include eating a high-fiber
diet, add bulk formers, drinking 8-12 cups
of water each day, regular exercise or various
medical therapies (stool softeners, laxatives,
enemas). |
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Sexual dysfunction
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48% - 75% of people with
MS report experiencing sexual difficulties which
may be caused by both physical and emotional aspects
of MS. |
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Men may have
difficulty achieving or maintaining an erection,
decreased genital sensation, difficulty with ejaculation
or fatigue and/or decreased interest in sexual intimacy. |
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Women may have issues with
fatigue, decreased sexual desire, loss or orgasm,
reduced/altered/painful sensations, vaginal dryness,
anxiety about incontinence, and/or urinary tract
infections |
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Treatment options include,
resolving relationship issues, treating contributing
factors such as fatigue, incontinence, spasticity
pain and hormonal and psychophysiologic issues,
as well as prescription medications, lubricants
or eliminating medications with potential side-effects. |
Cognitive difficulties
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Occurs in 43% - 65% of people
with MS |
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Symptoms include:
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Difficulties with problem-solving
and multi-tasking |
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Slowed
thinking |
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Short-term memory
loss/forgetfulness |
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Difficulty with visual
representation and spatial relationships |
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Personality changes |
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Language problems |
|
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Treatment of cognitive dysfunction
can involve several approaches, including the use
of disease-modifying therapy, treatment of fatigue
and depression through psychotherapy, avoiding aggravating
factors (sleep deprivation, substance abuse), pursuing
speech and occupational therapy for cognitive rehabilitation,
and pharmacologic therapy with cholinesterase inhibitors. |
Depression
|
Depression is the most common
mood symptom of MS, affecting between 47% and 54%
of people with MS |
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Can be caused
by MS-related neurological changes, challenges of
living with MS, or disease-modifying therapies |
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Consult with your healthcare
provider immediately if you suspect you are depressed. |
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Treatments for depression
can include prescription medications, psychotherapy
or counseling, exercise and effective treatment
of other MS symptoms |
Numbness, tingling
Muscle weakness and balance issues
Vision changes
Spasticity
|
Between 40% and 80% of MS
patients experience some degree of spasticity. |
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Spasticity is
defined as involuntary muscle stiffness or sudden
muscle contractions and movements such as stiff
or tight-feeling muscles or painful spasms or twisting
limbs. |
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Spasticity often results
from the MS demyelination process that attacks the
nerves controlling muscle tone. |
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Treatments for spasticity
include various muscle-relaxing drugs, physical
therapy, occupational therapy, braces/splints and
other prescription medications. |
Pain
How MS Affects Nerve Cells
The human brain contains millions of nerve cells, known
as neurons. Each neuron is insulated by a myelin sheath,
which helps nerve impulses reach their targets. With
patients who have MS, the myelin sheath that protects
the neuron is damaged by repeated attacks by antibodies
from the immune system. If the damage is severe enough
over time, the neuron may become cut and no longer transmit
nerve impulses.
Types of MS
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Relapsing-remitting
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Most common form of
MS |
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55% of
patients have this form |
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In this form of MS
there are unpredictable relapses during which
new symptoms appear or existing symptoms become
more severe. This can last for days or months
and there is partial recovery between relapses.
The disease may be inactive for months or
years. |
|
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Secondary progressive
|
30% of patients have
secondary progressive MS |
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Patients
with relapsing-remitting MS convert to secondary
progressive MS gradually over time. |
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With Secondary-progressive
MS, symptoms become steadily worse. |
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Primary progressive
|
5-10% of patients have
this form of MS |
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This form
of MS is characterized by a lack of distinct
attacks, but with slow onset and steadily
worsening symptoms. There is an absence of
distinct relapses. |
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Benign MS
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Less than 5% of patients |
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Complete
recovery between relapses |
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Treatment Options for MS
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Disease-modifying
treatments
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Interferon Beta Agents
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There are currently
three FDA-approved interferon agents |
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Interferon
beta drugs can help limit the excessive
attacks from the body’s immune
system on the neurons thereby reducing
the damage to the neurons. |
|
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Glatiramer Acetate
– there is currently one FDA-approved
glatiramer acetate therapy |
|
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Immunosuppressive
drugs
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Corticosteroids are
a kind of immunosuppressive drug that is used
for the treatment of relapses and is often
used in combination with other drugs to treat
aggressively for breakthrough disease |
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Care Team
Steven Zak,
M.D.
Charles Wang,
M.D.
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