Source:

Dr. HATEM SAMIR M. SHEHATA. 
PROFESSOR OF NEUROLOGY - CAIRO UNIVERSITY

NEVIN M. SHALABY. 
PROFESSOR OF NEUROLOGY - CAIRO UNIVERSITY
 
Dr. LOBNA ELNBIL 
PROFESSOR OF NEUROLOGY- AIN SHAMS UNIVERSITY

MS Symptoms

Presentation of MS often varies among patients. Some patients have a predominance of cognitive changes, while others present with prominent ataxia, hemiparesis or paraparesis, depression, or visual symptoms. Additionally, it is important to recognize that the progression of physical and cognitive disability in MS may occur in the absence of clinical exacerbations.
Classic MS symptoms are as follows:

• Sensory loss or paresthesias.  Usually an early complaint
• Spinal cord symptoms (motor) - Muscle cramping secondary to spasticity
• Spinal cord symptoms (autonomic) - Bladder, bowel, and sexual dysfunction
• Cerebellar symptoms - Charcot triad of dysarthria, ataxia, and tremor
• Optic neuritis
• Trigeminal neuralgia - Bilateral facial weakness or trigeminal neuralgia
• Facial myokymia (irregular twitching of the facial muscles) - May also be a presenting symptom
• Eye symptoms - Including diplopia on lateral gaze; these occur in 33% of patients
• Heat intolerance
• Constitutional symptoms - especially fatigue (which occurs in 70% of cases) and dizziness; fatigue must be differentiated from depression (which may, however, coexist), lack of sleep, and exertional exhaustion due to disability
• Pain - Occurs in 30-50% of patients at some point in their illness
• Subjective cognitive difficulties - With regard to attention span, concentration, memory, and judgment
• Depression - A common symptom
• Euphoria - Less common than depression
• Bipolar disorder or frank dementia - May appear late in the disease course but is sometimes found at the time of initial diagnosis.
• Symptoms associated with partial acute transverse myelitis

Patients with MS may present with many other manifestations, including the following:
Aphasia or dysphasia (occurs very rarely)
Seizures (5% of patients with MS)
Other paroxysmal symptoms (eg, ataxia, akinesia, paresthesias, pruritus)
Significant motor complaints without sensory deficits or dysautonomia
Paroxysmal symptoms may occur in bouts and are often triggered by movement or sensory stimuli.