Early Symptoms of Multiple Sclerosis

By Kathleen Doheny. Medically reviewed by Tom Iarocci, MD. May 7th 2016

It's not always easy to detect the initial signs of multiple sclerosis, or MS, a condition whereby your own immune system attacks your central nervous system, including your brain, spinal cord, and the optic nerves of your eyes.

That's because the early symptoms of this chronic disease that affects the central nervous system — the brain and spinal cord — can vary remarkably from person to person. Some symptoms are often ignored as nothing serious, or blamed on other conditions.

However, becoming aware of possible symptoms of multiple sclerosis and getting a medical evaluation if you do notice them can help insure a prompt diagnosis. Getting diagnosed early means treatment can be started as soon as possible.

Doctors think that is best for a patient, a way to minimize the disability that can occur with MS, including loss of balance, cognitive problems and vision loss.

"We think that making an early diagnosis of MS and treating it early on probably increases the chances the patient will do well," says Aaron Miller, MD, professor of neurology and medical director of the Corinne Goldsmith Dickinson Center for MS at the Icahn School of Medicine at Mount Sinai. He is also a medical advisor to the National Multiple Sclerosis Society and sits on its board of directors.

MS: Early Signs and Symptoms

About 2.3 million people worldwide have MS, including about 400,000 in the U.S., according to the National Multiple Sclerosis Society. The diagnosis is most common between ages 20 and 50.

Miller says there are some clues to deciding which symptoms warrant a call to the doctor. "Generally, first signs of MS, and the most common, are sensory such as numbness and tingling, sometimes in one limb, sometimes in multiple," he says. "We all get pins and needles from time to time. That's not really a cause of concern. If you get them and it lasts for a day or longer, that's worrisome."

Maybe the most common early symptom is eye pain with vision problems, a condition known as optic neuritis. It’s almost always just one eye that’s predominantly affected. "The patient has pain on eye movement and a change in vision," Miller says.  Some say they feel like they are looking through fogged-up glass, he adds.  

Other common symptoms that warrant seeking medical help:

  • Weakness in one or more limbs,
  • Double vision, and
  • Unsteady walking.

Pain an also be part of the spectrum for people with MS.

Telltale Tingling and Numbness

People tend to ''blow off'' the tingling and numbness as nothing serious, Miller says. Less so the other symptoms, he adds. "Most people pay attention when they have visual changes or weakness."

It's important to pay attention to all these possible symptoms, Miller says. Even if the symptoms persist, then go away, it could still be MS. "Typically, attacks of MS resolve within days to a couple weeks, even if they don't get treated."

So, symptoms such as tingling and numbness that are constant then go away shouldn't be dismissed. It's important to get checked out as soon as possible by a neurologist.

"The doctor will take a detailed history and do a neurological exam," he says. An MRI scan of the brain and spine may be done. It may detect specific white spots that can signal the presence of MS. Certain blood tests may also be ordered to rule out other conditions.

If the diagnosis is MS, experts believe that treating MS early is best, although it's not definitive, Miller says. "It's been difficult to prove that going on the [MS] medicine early actually protects the patient over many years from long-term disability, but we think that is the case."

Next Steps

For Patients

If the diagnosis is MS, there is much more you can do to help yourself in addition to starting MS medications.

  • Exercise daily. Regular, moderate daily physical activity protects general health, boosts your energy and improves the MS fatigue, says Miller.
  • Reduce stress. In one study, researchers found that a weekly stress management program, such as meditation or yoga, was very helpful. It appeared to prevent the development of new brain lesions, considered an indication of the disease activity.

For Family Caregivers

  • If you notice a loved one is suddenly having problems with fatigue, balance, eye pain or he complains of numbness, encourage him to see a doctor.
  • If you know someone with MS, you can offer to join them in workouts or support them in other ways. The National Multiple Sclerosis Society has a guide for caregivers. 

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