Multiple sclerosis (MS) is a disorder of the central nervous system (brain and spinal cord). In this condition, the immune system targets the protective sheath that shields the nerve fibers, which causes communication problems between the brain and the body. This condition can cause permanent damage to the nerve fibers. Warning signs and symptoms of multiple sclerosis vary between patients. Some of the most common early signs of MS are listed below.

1) Clinically Isolated Syndrome (CIS)- In some patients, the earliest indicator of MS is CIS. This episode lasts 24 hours, and one may experience neurologic symptoms that cannot be associated with another cause, some of which are listed below.

• Optic neuritis- This condition causes damage to the myelin of the optic nerve, leading to vision problems and eye discomfort.
• Lhermitte’s Sign- This is caused by a lesion on the spinal cord, which causes a tingling or shock sensation in the back and the neck, especially when one bends their neck.
• Transverse myelitis- This affects the spinal cord and may cause muscle weakness, numbness, and other issues.

2) Fatigue- Fatigue is one of the most common indicators of MS. It is described as exhaustion that makes it difficult to carry out one’s daily activities. It may worsen at the end of each day, after exercising, and during illness.

3) Vision problems- Vision problems, or optic neuritis, occurs in 1 in 4 cases of MS. Some of these include-

• Temporary loss of vision in the affected eyes that may last for days or weeks
• Color blindness
• Eye pain
• Flashes of light when moving the eye
• Double vision
• Involuntary eye movements

4) Numbness or tingling- People with MS may experience abnormal sensations such as numbness and tingling in their arms, legs, or trunk, which may last a few days.

5) Muscle spasms and stiffness- MS can also cause muscles to contract tightly and painfully or become stiff and resistant to movement.

6) Mobility problems- Due to muscle weakness and spasms, one may also experience mobility problems, such as clumsiness, difficulty in balance or coordination (ataxia), shaking of the limbs, and dizziness or vertigo.

7) Pain- People with MS may experience the pain of two types-

• Neuropathic pain- This pain is caused by damage to the nervous system and manifests as stabbing pains in the face or sensations such as pins and needles, burning, or squeezing in the limbs.
• Musculoskeletal pain- People with MS may also experience pain that is indirectly caused by MS, such as pressure on the lower back and hips when walking or moving.

8) Sexual concerns – MS can impact one’s sexual activity as well. Men with MS may experience erectile dysfunction. On the other hand, women with MS may experience issues like vaginal dryness or reduced sex drive.

9) Cognitive problems- Some people may experience cognitive dysfunction. It may occur in the form of-

• Problems in learning or remembering new things
• Slowing down when processing lots of information or multitasking
• Reduced attention span
• Getting stuck on words
• Problem with understanding or processing visual information
• Experiencing difficulty in planning and problem-solving
• Problems with reasoning, such as mathematical laws or solving puzzles

In rare cases, those with MS may also experience mood swings, such as suddenly bursting into tears, laughing, or shouting angrily. People with MS are more likely to experience symptoms of anxiety. However, it is unclear whether these problems are caused as a symptom of MS or due to the stress of managing this chronic disorder.

10) Bowel and bladder problems- Bladder and bowel problems are common with MS. These include-

• Having to pee more frequently
• Experiencing a sudden urge to pee and passing urine unintentionally (urinary incontinence)
• Difficulty emptying the bladder completely
• Having recurrent urinary tract infections (UTIs)
• Constipation
• Bowel incontinence

11) Difficulty in speech or swallowing- Some people with MS may develop dysphagia or difficulty chewing or swallowing. They may also develop dysarthria, which causes speech to become slurred or difficult to comprehend.

MS can happen to people of any age, but it is most frequently diagnosed between 20 and 40. Many people experience MS symptoms for years before receiving a proper, confirmed diagnosis. However, an early diagnosis and prompt treatment can help delay the formation of new lesions, reduce the risk of brain atrophy, and lower the relapse rate.