Early Signs of Multiple Sclerosis

Early Signs of Multiple Sclerosis: What to Look Out For

Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system (CNS), leading to a wide range of symptoms. Early detection is crucial, as it can significantly impact treatment and long-term outcomes. Here, we’ll explore the early signs of MS and what to look out for.

Clinically Isolated Syndrome (CIS)

CIS refers to a person’s first-time episode of neurological symptoms caused by inflammation and damaged myelin in the CNS. This can occur within a few hours or take a week or two to develop if it affects the spinal cord, or hours to days if it involves vision. A patient diagnosed with CIS may experience numbness and tingling in their legs, which is evaluated by magnetic resonance imaging (MRI) findings that reveal damage to the CNS.

Optic Neuritis

Optic neuritis, or inflammation of one of the two optic nerves, is a common first presentation of MS. This can be diagnosed from an attack of optic neuritis. The symptoms include:

• Blurry vision
• Dim vision, as if the lights were turned down
• Color vision changes, especially red and green
• Pain in the back of the eye socket
• Pain when moving the eyes

Other Common Symptoms

While the symptoms of MS vary in type, severity, and duration, some common ones include:

• Vision problems, such as nystagmus (uncontrolled, jerking movement of the eyes)
• Muscle weakness
• Dizziness
• Fatigue
• Muscle spasms
• Pain
• Bladder problems
• Constipation

How MS is Diagnosed

Diagnosing MS is often challenging, as the symptoms can be variable and similar to those of other conditions. A neurologist will use the following tools to confirm a diagnosis of MS:

• Medical history and neurological exam
• The McDonald criteria, which focus on diagnosing MS by showing evidence of damage to the CNS at different dates and to different parts
• Magnetic resonance imaging (MRI) of the brain and spinal cord
• Laboratory tests, mostly to rule out other conditions
• Other tests, including a spinal tap (lumbar puncture) and evoked potential tests (which measure electrical activity of the nerves of the eye)

A Word From Verywell

If you’re concerned that you may be experiencing possible symptoms of MS, schedule an appointment with your healthcare provider or a neurologist. Diagnosing and treating MS as early as possible is associated with better long-term outcomes. Keep in mind that many symptoms of MS overlap with other common medical conditions. Be proactive and get checked out, but try not to worry yourself until you know more information.

Frequently Asked Questions

1. What age does MS usually start?
   Most people are diagnosed with MS between the ages of 20 and 50 years old. That said, MS can develop at any age, and symptoms may predate a diagnosis by years.

2. Can you have MS for years and not know it?
   Yes. In fact, research suggests MS may have a prodromal ("very early") phase. This phase includes various nonspecific symptoms, like fatigue, depression, pain, and headache, which may precede an MS diagnosis by several years.

3. Can a blood test show MS?
   No, there is no blood test that can diagnose MS. If you or a loved one are being evaluated for MS, your neurologist will use a variety of diagnostic tools, including your medical history, neurological exam, an MRI, and various blood or spinal fluid tests.

4. Will MS show up on an MRI?
   MS occurs when your immune system mistakenly attacks myelin, a protective coating on your nerves. These attacks lead to inflammation in the brain and spinal cord, which shows up as "lesions" or "plaques" on an MRI.