Symptoms change depending on where nerve damage is and how much there is. Patients can have vision problems if it goes to the nerves of the eye. This is sometimes one of the early problems. Other early symptoms can be sensory problems such as dizziness, numbness, tingling, burning feelings, and tight muscles in the legs. Fatigue is common and usually causes more problems than the other symptoms.

Common MS symptoms:

• Fatigue
• Numbness, tingling (“pins and needles”), or burning sensation in hands, arms, or legs
• Weakness
• Chronic pain
• Balance and coordination problems
• Dizziness
• Heat sensitivity
• Slurred speech
• Partial or complete visual loss
• Double vision
• Trouble with attention, memory, and other thinking skills
• Sleep problems (e.g., restless leg syndrome)
• Depression
• Bowel and bladder problems
• Sexual dysfunction

Subtypes of Multiple Sclerosis

There are four subtypes of MS. Some people change from one kind to another as the disease goes along, while others stay the same.

Relapsing-remitting MS (RRMS): The most common subtype, seen in over 3/4 of MS patients. It is called “relapsing-remitting” because sometimes the disease gets worse (a relapse), followed by at least some recovery (remitting).

Secondary progressive MS (SPMS): Most people with the first type of MS will change to this type of MS over the course of 10-20 years. Symptoms get worse over time, but there are sometimes periods of improvement.

Primary progressive MS: This subtype is seen in about 10% of MS patients and is more difficult to treat. Symptoms become steadily worse from the beginning without any times when they get a lot better, although there may be times when they stay the same.

Progressive-relapsing MS: This is an uncommon type. Only about 5% of patients with MS have this. Symptoms become slowly worse from the beginning with times when they get much worse. There are no times when they get much better.

Cognition in Multiple Sclerosis

Most people with MS have problems with their thinking, like problems with paying attention or remembering things. These problems can lead to having a hard time working or doing other everyday tasks. Sometimes these problems aren’t noticed at first because problems seeing or walking may seem more important.

Common Thinking Problems:

• Thinking more slowly
• Having trouble pulling up words or memories
• Problems with paying attention
• Difficulty doing complicated things, or trying to do a few things at once
• Trouble with telling where things are, which can lead to accidents
• Feeling like it’s hard to think because of feeling fatigued

There are some ways to work around these problems. You could try:

• Working on one thing at a time
• Keeping things you need a lot (like glasses, wallets, phones, or keys) in the same place all the time so they don’t get lost
• Scheduling more time to do things, especially things that are complicated
• Keeping lists or a planner to help track things to do
• Using a pill box to manage medications, or even getting an automated pill dispenser
• Setting reminders on your phone to help remember things
• Getting more sleep, or allowing time for naps to reduce fatigue
• Getting rid of things that can cause accidents, like rugs that are easy to trip over

Prognosis – How MS Changes over Time

For many people, MS symptoms do get worse over time. Problems with motor skills can cause difficulties with driving, and even eventually with walking. Many people keep working for years after their diagnosis, but for a lot of people their symptoms keep them from working at some point. Most people find it takes them longer to do things than it used to, and there may be some everyday things they cannot do at all. If symptoms become very bad, the person with MS may need a caretaker to help with everyday tasks.