Multiple sclerosis (MS) results from an immune system attack on nerve cells in the brain and spinal cord. The attack destroys the protective insulation around these cells, ruining their ability to send and receive accurate signals. No two people with MS will experience the exact same pattern of destruction, so no two people will have the exact same pattern of symptoms.
For this reason, MS is a difficult disease to pin down. Another reason it’s so tough to diagnose, according to the National MS Society, is that many of the early symptoms can be associated with a number of other neurological conditions or even the rigors of a busy life. After all, plenty of people who do not have MS will feel fatigue or have the occasional bout of dizziness—two common, early symptoms of the disease.
Some other early symptoms are less a part of daily life, however.
Numbness and tingling
For many people with MS, feelings of pins and needles or a lack of sensation are their first hints of a problem. The buzzes, tingles and loss of feeling can occur anywhere from the head to the toes.
Vision problems
Blurry vision, double vision or pain and vision loss—caused by an inflammatory condition called optic neuritis—are also among the first symptoms people with MS notice. Issues with depth perception and color may also occur, and eventually, you may experience involuntary eye movements or a large spot in the center of your vision.
Dizziness and vertigo
If the room is spinning, that’s called vertigo. A feeling of lightheadedness is dizziness. Either of these symptoms can be an early indicator of MS.
Pain
Pain occurs in about half of people with MS and comes in many forms. Some people feel their first MS symptom when they experience Lhermitte’s sign, an electrical shock down the spine that occurs with bending the head forward. This symptom is sometimes called “barber chair syndrome” because of the motion of the head that elicits it—the same movement you make so the barber can shave your neck.
Walking difficulties
Another early symptom of MS can be trouble walking. Healthcare practitioners may call it “gait difficulty,” which can arise because of effects on the brain’s signals to the muscles, balance problems, or numbness that blocks sensation of where the feet are.
Brain fog and depression
Some people with MS get a feeling of “cog fog”—cognitive fog—and struggle with memory, learning and finding words. Sometimes, this sensation of a woolly brain can be the first hint of MS. Mental health can take a hit, too: depression sits near the top of the list of common symptoms of MS.
Spasticity
Though it can happen in other limbs, muscle stiffness in MS strikes the legs most often, and can cause painful spasms and changes in gait.
Weakness
Weakness in MS can arise from disrupted signals to muscles or from disuse because of other problems, such as fatigue. Although people probably think most often of weak legs, weakness can occur in any muscles.
MS strikes at the human body’s central processing system—the brain and spinal cord—so it leaves few systems untouched. In addition to the symptoms above, other early signs of MS can include emotional changeability and bladder and bowel difficulties. Where symptoms initially arise depends on which parts of the central nervous system MS strikes first.
Having one or more of these symptoms could indicate MS, though the problem may be something else entirely. Either way, book a visit with your doctor to be sure. To determine whether it's related to MS, they'll take a thorough medical history, conduct neurological and physical exams and run a number of tests to rule out other conditions. The earlier MS is diagnosed, the faster treatment can begin, leading to a higher quality of life.
