MS Symptoms (1) - Movement, Memory and Emotions

What are the symptoms of MS?

MS is a complex illness and there are many symptoms  - not every person gets every symptoms and its unusual for someone to have all the symptoms (I am one of the rare ones). The symptoms depend on which areas of the central nervous system have been affected e.g where the lesions are on the brain. 

The symptoms vary from time to time and change in severity and duration, even in the same person.

The most common MS symptoms are fatigue, pain, bladder, bowel, movement, weakness and balance problems, visual and sensation problems, cognition and mood changes, but any neurological symptom or sign may be part of a person's MS.

While some MS symptoms are immediately obvious, others such as fatigue, altered sensation, memory and concentration problems are often hidden symptoms. These can be difficult to describe to others and sometimes family and carers do not understand the effects these have on the person with MS and on employment, social activities and quality of life. It is an invisible illness.

Movement/Balance

One of the things my neurologist said to be when I was diagnosed, "you can do any job but I don't advise tight rope walking" - this is due to balance, unstable walking and being dizzy (vertigo). There goes my dream job!!

It is thought that movement problems are caused by myelin damage in the cerebellum and its connections, which impairs the workings of the network, causing uncoordinated movements. A loss of balance and vertigo has been found to be due to lesions in the complex pathways that coordinate visual, spatial and other input to the brain needed to produce and maintain body equilibrium.

Other symptoms which affect movement and balance are:

• tremor
• clumsiness of a limb
• lack of coordination
• muscle weakness
• tightness, stiffness or 'pull' of muscles (spasticity)
• involuntary muscle spasms

Cognitive Problems

Cognition refers to the“higher” brain functions such as memory and reasoning. About half of all people with MS will not experience any cognitive changes, but for others, the most commonly affected aspects of cognition are:

• Memory
• Attention and concentration
• Word-finding
• Speed of information processing
• Abstract reasoning and problem solving
• Visual spatial abilities
• Executive functions

Because MS can affect any part of the brain, almost any cognitive function can be impaired, and symptoms can range from having a mild impact on only one or two aspects through to more pervasive changes, which affect a person's daily life.

Cognitive changes can have a significant impact on a person's ability to work and fulfill family responsibilities. Family members and friends may not realise that MS can cause cognitive problems and this misunderstanding can result in anger and confusion.

Emotional

Having cognitive problems is distressful and can cause stress and anxiety which on top of having to deal with the diagnosis, illness and changes to life brings on emotional responses. 

Being diagnosed with any serious illness can be likened to a death as you go through the grieving process – grieving for life before MS and self-image. This takes a while, its not an overnight experience, as you have cope with MS and incorporate it into your existing life.

Other emotional changes that may occur in MS include clinical depression,bipolar disorder and mood swings. All of these are more common among people with MS than in the general population. Depression and bipolar disorder require professional attention and the use of effective treatments.

Emotional liability appears to be more common, and possibly more severe,in people with MS and includes frequent changes in mood from happy to sad to angry, for example. It is believed that the causes are both the extra stress brought on by MS as well as neurological changes at work. Uncontrollable laughing and crying is a disorder affecting a small proportion of people with MS, and is thought to be caused by MS-related changes in the brain.