Having a diagnosis of multiple sclerosis (MS) can make you confused, nervous, and scared. Unfortunately, that is a natural reaction, and you’re not alone. In recent years, the cases of MS have increased around the world [1]. While multiple sclerosis (MS) symptoms can vary from patient to patient, several signs and symptoms are known to occur early in the disease. You’ll learn about multiple sclerosis’s early signs and symptoms in this article. Is MS hereditary? What are the risk factors of MS and comorbid diseases?
What is Multiple Sclerosis?
According to a study review published in the European Journal of Neurology, MS is the commonest non-traumatic disabling disease to affect young adults [2]. Multiple sclerosis, also known as MS, is an unpredictable autoimmune disease that attacks the central nervous system (the brain and spinal cord). It’s characterized by periods of remission followed by flare-ups that cause symptoms like numbness and paralysis, loss of balance or vision, and pain, among many others. MS can take years to develop. While there’s no cure, there are ways to manage the disease so it doesn’t interfere with your daily life. One of the best ways to get an MS diagnosis early on is by knowing its early signs and symptoms [3].
Early Signs and Symptoms of Multiple Sclerosis
Image by brgfx on Freepik
You must know how to identify the early signs and symptoms of MS; it can help you get a proper diagnosis and treatment options that work best for you. Plus, knowing how to diagnose multiple sclerosis can help you feel more informed about your condition, and better control it. So if you’re experiencing any of these early signs and symptoms, talk to your doctor as soon as possible about how to diagnose multiple sclerosis.
Common signs and symptoms of multiple sclerosis are [3,4]:
- Muscle weakness or numbness
- The trouble with coordination and balance
- Changes in vision
- Fatigue
- Tingling or pain in the body
- Problem with bowel and bladder function
- Mood changes
1) Muscle weakness or numbness
One of the early signs and symptoms of MS is muscle weakness or numbness. The National Multiple Sclerosis Society says that up to 60 percent of people with MS have muscle weakness in their arms, legs, or face. Muscle weakness can be caused by an MS-related condition called myasthenia gravis. If you experience muscle weakness as a symptom for more than three months, consult a doctor. You should also see a neurologist if you experience these other symptoms along with muscle weakness or numbness: Loss of balance, sensitivity to heat or cold, problems swallowing, Stiff neck, walking difficulties, and weakness on one side of your body.
2) Trouble with coordination and balance
You may observe trouble with coordination and balance as an early symptom of MS. The most common symptom is dizziness, which may happen a few times throughout the day. Your symptoms can get worse when you’re stressed or tired. You may also notice you’re more likely to stumble or fall when walking than before your diagnosis.
3) Changes in vision a sign of MS
It could be a sign of multiple sclerosis if you experience changes in your vision, such as blurred or double vision. Other symptoms include an inability to focus on objects when reading or driving, light sensitivity, and eye pain. However, other severe conditions can cause these changes in the eyes, so contact your doctor if you are concerned about this symptom.
4) Fatigue
Fatigue is one of the most common symptoms of multiple sclerosis. This can be due to the disease or as a side effect of some medications. Fatigue can affect your cognitive abilities, your ability to work, and your quality of life. It may also worsen muscle weakness and make it hard to sleep. You may find that fatigue comes in waves and lasts for hours, days, weeks, or even months. Talk to your doctor if you notice any unusual tiredness that doesn’t go away with rest because MS might cause it.
5) Tingling or pain in your body
There are several early warning signs or symptoms that can be indicative of multiple sclerosis. These include tingling in your limbs, pain in your extremities, unexplained fever, vertigo, or difficulty swallowing; toes could feel like pins and needles (sensory nerve damage). If you experience any one of these symptoms and they persist for more than 24 hours, it is recommended that you see a physician as soon as possible.
6) Problems with bowel and bladder function
Bowel and bladder function symptoms in MS vary from person to person but can include not being able to urinate, incontinence, constipation, or diarrhea. Problems may be more common in the morning when people are dehydrated, as dehydration worsens some of these symptoms. Some people may also experience a tingling sensation around the anus or genitals called pudendal neuralgia, which could indicate nerve damage.
7) Mood changes
Mood changes can be one of the first symptoms of multiple sclerosis you may experience. When you’re feeling down or depressed for no reason, it may be because your brain misinterprets messages from your spinal cord. It’s essential to take note
of these mood changes because they can indicate that something serious is going on in your body. Mood changes are also a symptom of depression, so if you have multiple sclerosis and are experiencing depression, it’s essential to get treatment for both conditions as soon as possible.
Risk Factors of Multiple Sclerosis
Several environmental factors and lifestyles may increase your exposure to MS [3]. For example, multiple sclerosis is common in women. In addition, the sex ratio of MS has been on a steady rise, and it is now close to 3:1 (Female: Male) in most developed countries [5].
Some risk factors of MS are [6]:
- Vitamin D OR Ultraviolet B light exposure
- Epstein-Barr virus (EBV)
- Infection
- Obesity
- smoking
Is MS Hereditary?
Your chance of having MS occurs throughout life, starting in the womb. Your genetic makeup influences your susceptibility to MS [3]. Environmental factors can trigger MS if you have a family history of the disease. Your risk of developing MS when you have a first-degree relative with Multiple sclerosis is around 5%, 25% if you’re identical twins, and higher chances if present in the family history.
Genetics contribute to the occurrence of MS from country to country. For example, the gene HLA-DRB1 has the most dominant risk factor seen in MS., Although genetic makeup does not affect the severity and type of multiple sclerosis.
For example, you may find that when MS affects an identical twin, one twin can have mild MS that comes and goes away, while the other’s condition may be more severe with serious long-term effects [6].
Comorbid Disorders
A big red flag to check for MS is comorbid symptoms and signs. These signs help doctors differentiate MS from other autoimmune diseases with similar signs and symptoms as multiple sclerosis. MS can coexist with other autoimmune disorders, such as [7][8]:
- Systemic lupus erythematosus
- Sjögren’s disease
- Behçet’s disease
- Susac’s disease
- Other vasculitides
- Lyme disease
- HIV
- Parkinson’s disease
- Rheumatoid Arthritis
- Alzheimer disease
- Inflammatory bowel disease
How to Diagnose Multiple Sclerosis
There is no single, defined test for multiple sclerosis. Your doctor will only diagnose you with MS after ruling out other diseases or comorbid disorders that might be causing your symptoms. MS is a journey from being at risk phase to the- symptom phase, introductory phase, and presence of symptoms phases of the disease.
The diagnosis of multiple sclerosis remains clinical. However, once all the signs and symptoms of MS are known, you will get either of the following diagnoses.
Differential diagnosis:
Your doctor separates between two or more conditions that could be causing your symptoms.
Diagnosis of exclusion:
Your doctor decides to diagnose it as MS by elimination because they could not conclude with confidence the cause of your symptoms from your history, examination, or test.
Diagnostic Test for MS Diagnoses
Standard diagnostic tests and tools used by doctors to diagnose MS are [3].
- Physical examination
- Medical history
- Magnetic resonance imaging (MRI)
- Antibody test
- Spinal tap
- Blood test
Conclusion
Multiple sclerosis, also known as MS, is an unpredictable autoimmune disease that attacks the central nervous system (the brain and spinal cord). It’s characterized by periods of remission followed by flare-ups that cause symptoms like numbness and paralysis, loss of balance or vision, and pain, among many others. While there’s no cure, there are ways to manage the disease so it doesn’t interfere with your daily life.
One of the best ways to get an MS diagnosis early on is by knowing its early signs and symptoms. So if you experience any of these symptoms, consult your doctor immediately to rule out MS as a cause.
References
- Browne P, Chandraratna D, Angood C, Tremlett H, Baker C, Taylor BV, et al. Atlas of Multiple Sclerosis 2013: A growing global problem with widespread inequity. Neurology [Internet]. 2014 Sep 9 [cited 2022 Nov 11];83(11):1022–4. Available from: https://www.neurology.org/lookup/doi/10.1212/WNL.0000000000000768
- Kobelt G, Thompson A, Berg J, Gannedahl M, Eriksson J, the MSCOI Study Group, et al. New insights into the burden and costs of multiple sclerosis in Europe. Mult Scler [Internet]. 2017 Jul [cited 2022 Nov 11];23(8):1123–36. Available from: http://journals.sagepub.com/doi/10.1177/1352458517694432
- Dobson R, Giovannoni G. Multiple sclerosis – a review. Eur J Neurol [Internet]. 2019 Jan [cited 2022 Nov 11];26(1):27–40. Available from: https://onlinelibrary.wiley.com/doi/10.1111/ene.13819
- Mollaoğlu M, Üstün E. Fatigue in multiple sclerosis patients. Journal of Clinical Nursing [Internet]. 2009 May [cited 2022 Nov 11];18(9):1231–8. Available from: https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2702.2008.02733.x
- Orton SM, Herrera BM, Yee IM, Valdar W, Ramagopalan SV, Sadovnick AD, et al. Sex ratio of multiple sclerosis in Canada: a longitudinal study. The Lancet Neurology [Internet]. 2006 Nov [cited 2022 Nov 11];5(11):932–6. Available from: https://linkinghub.elsevier.com/retrieve/pii/S147444220670581
- Baecher-Allan C, Kaskow BJ, Weiner HL. Multiple sclerosis: mechanisms and immunotherapy. Neuron [Internet]. 2018 Feb [cited 2022 Nov 11];97(4):742–68. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0896627318300461
- Ascherio A. Environmental factors in multiple sclerosis. Expert Review of Neurotherapeutics [Internet]. 2013 Dec [cited 2022 Nov 11];13(sup2):3–9. Available from: http://www.tandfonline.com/doi/full/10.1586/14737175.2013.865866
- Makhani N, Tremlett H. The multiple sclerosis prodrome. Nat Rev Neurol [Internet]. 2021 Aug [cited 2022 Nov 11];17(8):515–21. Available from: http://www.nature.com/articles/s41582-021-00519-3
