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Medical Author:

Fernando Dangond, MD

Medical Editor:

Jay W. Marks, MD

Jay W. Marks, MD

Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

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Medical Editor:

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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In this Article

• Multiple sclerosis facts
• What is multiple sclerosis?
• What causes multiple sclerosis?
• Is multiple sclerosis inherited?
• What are the types of multiple sclerosis?
• What are the symptoms of multiple sclerosis?
• How is multiple sclerosis diagnosed?
• What are the treatments for multiple sclerosis?
• Interferons for relapsing multiple sclerosis
• Other medications approved for relapsing multiple sclerosis
• How are the physical manifestations of multiple sclerosis treated?
• What are the future directions for managing multiple sclerosis?
• Multiple Sclerosis (MS) FAQs
• Patient Comments: Multiple Sclerosis - Symptoms
• Patient Comments: Multiple Sclerosis - Diagnosis
• Patient Comments: Multiple Sclerosis - Causes
• Patient Comments: Multiple Sclerosis - Treatments
• Patient Comments: Multiple Sclerosis - Type
• Find a local Neurologist in your town
• Multiple Sclerosis Index

There are different clinical manifestations of multiple sclerosis. During an attack, a person experiences a sudden deterioration in normal physical abilities that may range from mild to severe. This attack, sometimes referred to as an exacerbation of multiple sclerosis, typically lasts more than 24 hours and generally more than a few weeks (rarely more than 4 weeks).

About 65% to 80% of individuals begin with relapsing-remitting (RR) MS, the most common type. In this type, they experience a series of attacks followed by complete or partial disappearance of the symptoms (remission) until another attack occurs (relapse). It may be weeks to decades between relapses.

In primary-progressive (PP) MS, there is a continuous, gradual decline in a person's physical abilities from the outset rather than relapses. About 10% to 20% of individuals begin with PP-MS.

Those beginning with RR-MS can then enter a phase where relapses are rare but more disability accumulates, and are said to have secondary-progressive (SP) MS. About 50% of RR-MS individuals will develop SP-MS within 10 years. Over several decades, most RR-MS persons will experience progression to SP-MS. Progressive-relapsing (PR) MS is a type of multiple sclerosis characterized by a steady decline in abilities accompanied by sporadic attacks. There are cases of multiple sclerosis that are mild and can be recognized only retrospectively after many years and also rare cases of extremely rapid progression of multiple sclerosis symptoms (sometimes fatal) known as malignant or fulminant (Marburg variant) multiple sclerosis.

Symptoms of multiple sclerosis may be single or multiple and may range from mild to severe in intensity and short to long in duration. Complete or partial remission from symptoms occurs early in about 70% of individuals with multiple sclerosis.

• Visual disturbances may be the first symptoms of multiple sclerosis, but they usually subside. A person may notice a patch of blurred vision, red-to-orange or red-to-gray distortions (color desaturation), or monocular visual loss (loss of vision in one eye). Visual symptoms due to optic nerve inflammation (optic neuritis) in multiple sclerosis usually are accompanied or preceded by eye pain.
• Limb weakness with or without difficulties with coordination and balance may occur early.
• Muscle spasms, fatigue, numbness, and prickling pain are common symptoms.
• There may be a loss of sensation, speech impediment (typically a problem articulating words), tremors, or dizziness.

50% of people experience mental changes such as:

• decreased concentration,
• attention deficits,
• some degree of memory loss,
• inability to perform sequential tasks, or
• impairment in judgment.

Other symptoms may include:

• depression,
• manic depression,
• paranoia, or
• an uncontrollable urge to laugh and weep.

As the disease worsens, individuals may experience sexual dysfunction or reduced bowel and bladder control. Heat appears to intensify multiple sclerosis symptoms for about 60% of those with the disease. Pregnancy seems to reduce the number of attacks, especially during the third trimester.