Limited mobility and weakness (upper body and legs). Read more in our factsheets on balance and posture and moving well with MS. Muscle spasms, cramps and stiffness. People severely affected by MS often find it difficult to chew and swallow food.
Those symptoms include loss of vision in an eye, loss of power in an arm or leg or a rising sense of numbness in the legs. Other common symptoms associated with MS include spasms, fatigue, depression, incontinence issues, sexual dysfunction, and walking difficulties.
When the condition rapidly progresses, it is known as an acute form of the condition called fulminant multiple sclerosis. This condition is sometimes referred to as Marburg-type MS . This disorder causes destruction of the coating (myelin) that surrounds and protects nerve fibers (axons).
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.
In many patients, over a span of 5 to 15 years, the attacks begin more indolently, persist more chronically and remit less completely, gradually transforming into a pattern of steady deterioration rather than episodic flares.
Definition of aggressive MS
The authors of a 2020 review article suggest that aggressive MS is MS that presents with the following characteristics: frequent and severe worsening of MS symptoms, which doctors refer to as “MS relapses“ incomplete recovery from MS relapses. rapidly progressing and permanent disability.
Many people with RRMS will eventually develop secondary progressive MS (SPMS). This means they continue to have alternating flares and periods of recovery but will experience a steady worsening of symptoms. However, if a person has primary progressive MS (PPMS), their life expectancy is slightly lower at 71.4 years.
Average life span of 25 to 35 years after the diagnosis of MS is made are often stated. Some of the most common causes of death in MS patients are secondary complications resulting from immobility, chronic urinary tract infections, compromised swallowing and breathing.
Multiple sclerosis itself is not usually lethal, but it can increase the risk of long-term complications, such as infections or trouble swallowing, that can potentially shorten survival. On average, longevity is about five to 10 years shorter in people with MS.
The risk factor with the strongest and most conclusive evidence of a link to MS is infection with the Epstein-Barr virus (EBV).
Four disease courses have been identified in multiple sclerosis: clinically isolated syndrome (CIS), relapsing-remitting MS (RRMS), primary progressive MS (PPMS) and secondary progressive MS (SPMS).
Pulmonary complications.
MS can weaken the muscles that control the lungs. Such respiratory issues are the major cause of sickness and death in people in the final stages of MS.
Eventually, as many as 90 percent of these people reach a stage known as secondary-progressive MS (SPMS), in which symptoms gradually worsen and a person experiences increasing levels of disability. That might include more difficulty walking, loss of stamina, and cognitive problems.
Over time, symptoms stop coming and going and begin getting steadily worse. The change may happen shortly after MS symptoms appear, or it may take years or decades. Primary-progressive MS: In this type, symptoms gradually get worse without any obvious relapses or remissions.
Primary-Progressive MS
Also called Progressive Relapsing Multiple Sclerosis (PRMS), it is where MS goes from worse to worst. At this point, treatments do not work that well anymore, and the individual's life is greatly affected. PRMS is attributed to 10% of the population affected by MS.
While living with multiple sclerosis is a challenge, palliative care can make a big difference. Some palliative care treatments for MS include medications and techniques relieve muscle spasms, calm nerves, ease depression and manage pain. Palliative care teams treat your specific symptoms, whatever they may be.
Over time, more than two-thirds of people remain able to walk, although they may need an ambulation aid such as a cane or walker to do so. Some may choose to use a motorized scooter or wheelchair for long distances, in order to conserve energy and remain more active; others may need to use a wheelchair all the time.
MS can occasionally cause inappropriate behavior
A very small proportion of people with MS exhibit inappropriate behavior such as sexual disinhibition. This type of behavior is thought to result in part from MS-related damage to the normal inhibitory functions of the brain.
In MS, personality seems especially important, for in addition to frequent personality changes and disorders, patients have more dysfunctional personality profiles, characterized by low levels of Conscientiousness, Extraversion, and Agreeableness, and a high level of Neuroticism (Maggio et al., 2020).
True flares gradually worsen over the course of hours, consist of new "negative symptoms" or loss of function (weakness, vision loss, gait impairment, numbness), and will typically last multiple days. Symptoms that are brief and transient (lasting less than 24 hours) are not consistent with a flare.
15 years after diagnosis, about 50% of MS patients become dependent on at least a walking aid. The average time before having severe disability that causes patients to be restricted in bed is around 33 years.
Symptoms of advanced MS
Click the links to read more about these symptoms and how to manage them: Pain in muscles nerves and joints, and sensory changes. Bladder and bowel problems including incontinence, urinary tract infections and constipation. Limited mobility and weakness (upper body and legs).