Between 1 and 2 in every 10 people with the condition start their MS with a gradual worsening of symptoms. In primary progressive MS, symptoms gradually worsen and accumulate over several years, and there are no periods of remission, though people often have periods where their condition appears to stabilise.
Most symptoms develop abruptly, within hours or days. These attacks or relapses of MS typically reach their peak within a few days at most and then resolve slowly over the next several days or weeks so that a typical relapse will be symptomatic for about eight weeks from onset to recovery. Resolution is often complete.
Here's where MS (typically) starts
Although a number of MS symptoms can appear early on, two stand out as occurring more often than others: Optic neuritis, or inflammation of the optic nerve, is usually the most common, Shoemaker says. You may experience eye pain, blurred vision and headache.
Symptoms. Most commonly, MS starts with a vague symptom that disappears completely within a few days or weeks. Symptoms can appear suddenly and then vanish for years after the first episode, or in some cases never reappear. The symptoms of MS vary greatly and can range from mild to severe.
MS symptoms can come and go and change over time. They can be mild, or more severe. The symptoms of MS are caused by your immune system attacking the nerves in your brain or spinal cord by mistake. These nerves control lots of different parts of your body.
Numbness of the face, body, or extremities (arms and legs) is often the first symptom experienced by those eventually diagnosed as having MS.
People should consider the diagnosis of MS if they have one or more of these symptoms: vision loss in one or both eyes. acute paralysis in the legs or along one side of the body. acute numbness and tingling in a limb.
Sjogren's syndrome is an autoimmune disease that can mimic some of the symptoms of MS such as fatigue and joint pain.
While there is no definitive blood test for MS, blood tests can rule out other conditions that cause symptoms similar to those of MS, including lupus erythematosis, Sjogren's, vitamin and mineral deficiencies, some infections, and rare hereditary diseases.
Neurological examination
Your neurologist will look for abnormalities, changes or weakness in your vision, eye movements, hand or leg strength, balance and co-ordination, speech and reflexes. These may show whether your nerves are damaged in a way that might suggest MS.
MS is best detected by a neurological examination and painless imaging studies of the brain and spinal cord using magnetic resonance testing (MRI). An ophthalmologist also can use a test called an optical coherence tomography (OCT) to determine if the optic nerve has been affected by MS.
Clinically isolated syndrome describes a person's first episode of neurological symptoms caused by damaged myelin in the CNS. CIS is often referred to as the first stage of MS, even though it doesn't meet the MS criterion for dissemination in time (MS damage that occurs on different dates).
MS is usually diagnosed between the ages of 20 and 50, but it can go undetected for years. In fact, a 2021 study suggested that many people with MS experience disease symptoms several years before being officially diagnosed with the disease.
You might get a shocking, burning, squeezing, stabbing, cold, or prickly feeling out of nowhere. Some people call them zingers or stingers. These zaps usually last only seconds or minutes. They often affect your legs, feet, arms, and hands.
Neuropathic pain happens from “short circuiting” of the nerves that carry signals from the brain to the body because of damage from MS. These pain sensations feel like burning, stabbing, sharp and squeezing sensations. In MS you can experience acute neuropathic pain and chronic neuropathic pain.
A wide range of conditions can be mistaken for MS, including: migraine, cerebral small vessel disease, fibromyalgia, functional neurological disorders, and neuromyelitis optica spectrum disorders, along with uncommon inflammatory, infectious and metabolic conditions (1, 3).
There are no specific tests for MS . Instead, a diagnosis of multiple sclerosis often relies on ruling out other conditions that might produce similar signs and symptoms, known as a differential diagnosis. Your doctor is likely to start with a thorough medical history and examination.
Magnetic resonance imaging, or MRI, is a wonderful tool to help diagnose and follow people with MS. MRI is safe and relatively non-invasive yet can provide very detailed images of the brain and spinal cord that can reveal MS lesions (also known as demyelination, spots, or plaques) and changes in MS activity over time.
Fatigue. Feeling fatigued is one of the most common and troublesome symptoms of MS. It's often described as an overwhelming sense of exhaustion that means it can be a struggle to carry out even the simplest activities.
Devic's disease, also known as neuromyelitis optica (NMO) spectrum disorder, is a rare neuro-immune disorder that affects your eyes and your spinal cord. It may also attack the brain. Neuroimmune means that the immune system mistakenly attacks the nervous system as if it were a threat.
What age is multiple sclerosis usually diagnosed? While these MS symptoms can make everyday tasks more challenging (walking, say, or using your hands for things like texting or cooking), it's not related to the aging process. In fact, the average age range of diagnosis with MS is between 20 and 40.
Fatigue. About 80% of people with MS feel very tired, making it one of the most common symptoms. But a number of things can make you feel exhausted, including a sleep disorder, depression, or too little iron in your blood. MS fatigue tends to be worse than run-of-the-mill sluggishness.
About 15% of patients will never necessitate assistance with ambulation, while 5-10% will do so within 5 years, and another 10% will do so in 15 years. Average patient will take about 28 years from the point of diagnosis to necessitate assistance while walking, and will be about 60 years of age.