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Early recognition of MS symptoms is crucial for timely diagnosis and intervention. Audiovestibular manifestations, prodromal symptoms, and rare onset symptoms can serve as early indicators of the disease. Common symptoms such as cognitive impairment, motor and sensory disturbances, fatigue, and psychiatric symptoms significantly impact the lives of individuals with MS. Understanding these symptoms can aid in better management and improve the overall prognosis of the disease.
Multiple Sclerosis (MS) is a chronic, immune-mediated disease that affects the central nervous system (CNS). It is characterized by the demyelination of nerve fibers, leading to a wide range of neurological symptoms. Early diagnosis and intervention are crucial for managing the disease effectively. This article explores the early signs and common symptoms of MS, drawing on recent research findings.
Early Signs of MS
Audiovestibular Manifestations
One of the early signs of MS can be audiovestibular symptoms, which include issues related to hearing and balance. A scoping review identified that unilateral, moderate to profound sudden sensorineural hearing loss (SSHL) across all frequencies (250 Hz–8000 Hz) is a common early manifestation. Other symptoms include tinnitus, balance abnormalities, aural pain, and aural fullness. These symptoms are often linked to the immune-mediated mechanisms of MS affecting the peripheral structures of the inner ear1.
Prodromal Symptoms
Recent studies have suggested the existence of a prodromal phase in MS, characterized by non-specific symptoms that precede the classic neurological signs. These symptoms include fatigue, depression, anxiety, headache, sleep disturbances, pain, musculoskeletal disorders, gastrointestinal disorders, and genitourinary disorders. Recognizing these prodromal symptoms could provide a window of opportunity for early intervention and potentially better clinical outcomes2 6.
Rare Onset Symptoms
MS can also present with rare and unusual initial symptoms, complicating early diagnosis. These include pain syndromes, movement disorders, rare cranial nerve involvement, cognitive deficits, and psychiatric symptoms. Such atypical presentations often lead to diagnostic dilemmas, delaying the correct diagnosis of MS3.
Common Symptoms of MS
Cognitive Impairment
Cognitive impairment is a common symptom in MS, affecting various cognitive domains such as complex attention, information processing efficiency, executive functioning, processing speed, and long-term memory. These deficits can significantly impact daily life, including the ability to work, manage a household, and participate in social activities4.
Motor and Sensory Symptoms
MS typically presents with motor and sensory disturbances. Common motor symptoms include limb weakness, unsteadiness of gait, and spasticity. Sensory symptoms often involve numbness, tingling, and pain. These symptoms are usually due to the demyelination of nerve fibers in the CNS5.
Fatigue
Fatigue is one of the most prevalent and debilitating symptoms of MS, affecting the majority of patients. It can occur at any stage of the disease and significantly impacts the quality of life. Despite its prevalence, effective treatment options for MS-related fatigue are limited, highlighting the need for further research and novel therapeutic approaches7 9.
Psychiatric Symptoms
Psychiatric symptoms are also common in MS, with depression, anxiety, and bipolar disorder being the most frequently reported. These symptoms not only affect the quality of life but also influence other aspects of the disease, such as fatigue, sleep, and adherence to treatment8.