In multiple sclerosis, the immune system attacks myelin, a substance that protects the nerves of the brain and spinal cord and allows signals from the brain to the body to move more quickly. As a result, individuals with multiple sclerosis often have difficulty with movement, thinking and sensation. The symptoms and course of the disease vary by individual. Early symptoms may include numbness or tingling, weakness in one or more limbs, walking and balance difficulties, and visual disturbances. Other symptoms occur as the disease progresses.
Bladder and Bowel Difficulties
Bladder and bowel difficulties may arise if the nerves that control urination or bowel movements are damaged. Difficulties with the bladder may lead to a frequent need to urinate or urinary incontinence. Constipation is the most common bowel difficulty in those with multiple sclerosis. Other bowel difficulties include diarrhea and fecal incontinence.
Cognitive Difficulties
Cognitive difficulties occur in about half of individuals with multiple sclerosis, according to a study in the 1991 issue of "Neurology." Sometimes the cognitive difficulties are so severe that a person is unable to perform everyday tasks. Some cognitive difficulties include slowed thinking, decreased memory and decreased concentration. Difficulty with word retrieval is a common complaint of those with multiple sclerosis. Decreased concentration may lead to unfinished tasks, as distraction may inhibit the completion of tasks. Those with decreased memory may experience difficulty with remembering names, objects or things to do.
Fatigue
Fatigue is a common symptom of multiple sclerosis, affecting about two-thirds of individuals with the disease, according to a review of research in the June 2003 issue of "Multiple Sclerosis." Many individuals with multiple sclerosis report fatigue as the most disabling aspect of the condition. Fatigue slows down movement and thinking. Researchers are exploring the cause of fatigue, as the phenomenon is unknown at this time. The research review in the June 2003 issue of "Multiple Sclerosis" notes that fatigue in multiple sclerosis is not related to physical exertion and many individuals report fatigue after rest.
Movement Difficulties
Movements may become irregular or ineffective as multiple sclerosis progresses. Uncontrollable tremors, or shaking, may also occur in muscles in any part of the body. Speech may become slowed or slurred. Some individuals have difficulty swallowing. Muscle spasticity is also common. Spasticity is a condition in which muscles are continually contracted, which leads to stiff or tight muscles. This continued contraction often interferes with body movements, such as walking, dressing and talking. Some individuals experience mild stiffness. Others have more severe muscle spasticity that includes painful muscle spasms or posturing a limb at an unusual angle. Walking may be impossible for some with more severe spasticity.
References
- "Multiple Sclerosis"; Fatigue Associated with Multiple Sclerosis: Diagnosis, Impact and Management; Rahit Bakshi; 2003
- National Institute of Neurological Disorders and Stroke; Multiple Sclerosis: Hope Through Research
- "Neurology"; Cognitive Dysfunction in Multiple Sclerosis: Frequency, Patterns, and Prediction; Stephen Rao, Gary Leo, Linda Bernardin, and Frederick Unverzagt; 1991.
