Symptoms:

Symptoms vary, because the location and severity of each attack can be different. Episodes can last for days, weeks, or months. These episodes alternate with periods of reduced or no symptoms (remissions).

Fever, hot baths, sun exposure, and stress can trigger or worsen attacks.

It is common for the disease to return (relapse). However, the disease may continue to get worse without periods of remission.

Because nerves in any part of the brain or spinal cord may be damaged, patients with multiple sclerosis can have symptoms in many parts of the body.

Muscle symptoms:

• Loss of balance
• Numbness or abnormal sensation in any area
• Pain because of muscle spasms
• Pain in the arms or legs
• Problems moving arms or legs
• Problems walking
• Problems with coordination and making small movements
• Slurred or difficult-to-understand speech
• Tremor in one or more arms or legs
• Uncontrollable spasm of muscle groups (muscle spasticity)
• Weakness in one or more arms or legs

Eye symptoms:

• Double vision
• Eye discomfort
• Uncontrollable rapid eye movements
• Vision loss (usually affects one eye at a time)

Other brain and nerve symptoms:

• Decreased attention span
• Decreased judgment
• Decreased memory
• Depression or feelings of sadness
• Dizziness and balance problems
• Facial pain
• Hearing loss
• Fatigue

Bowel and bladder symptoms:

• Constipation
• Difficulty beginning urinating
• Frequent need to urinate
• Stool leakage
• Strong urge to urinate
• Urine leakage (incontinence)

Signs and tests:

Symptoms of MS may mimic those of many other nervous system disorders. The disease is diagnosed by ruling out other conditions.

People who have a form of MS called relapsing-remitting may have a history of at least two attacks, separated by a period of reduced or no symptoms.

The health care provider may suspect MS if there are decreases in the function of two different parts of the central nervous system (such as abnormal reflexes) at two different times.

A neurological exam may show reduced nerve function in one area of the body, or spread over many parts of the body. This may include:

• Abnormal nerve reflexes
• Decreased ability to move a part of the body
• Decreased or abnormal sensation
• Other loss of nervous system functions

An eye examination may show:

• Abnormal pupil responses
• Changes in the visual fields or eye movements
• Decreased visual acuity
• Problems with the inside parts of the eye
• Rapid eye movements triggered when the eye moves

Tests to diagnose multiple sclerosis include:

• Cerebrospinal fluid tests, including CSF oligoclonal banding
• Head MRI scan
• Lumbar puncture (spinal tap)
• Nerve function study (evoked potential test)
• Spine MRI