9 Symptoms of Multiple Sclerosis That Might Surprise You

The symptoms of multiple sclerosis (MS) vary greatly from person to person, and can get better or worse over time. More common symptoms include fatigue, walking (gait) difficulties, numbness or tingling, spasticity, weakness, vision problems, dizziness, bladder and bowel problems, sexual problems, pain, cognitive and emotional changes, and depression .

However, there are also some less common symptoms of MS. Here are some of the more surprising symptoms that you might not be aware of.

1. Vertigo

Many people with MS experience dizziness, in which you feel lightheaded or off balance.

A less-common MS symptom is vertigo . When you have vertigo, you feel as though your surroundings are spinning around you, or that you are spinning. Vertigo in MS is a result of lesions in areas of the brain that coordinate balance. Motion sickness drugs can usually provide temporary relief, but typically do not resolve chronic vertigo from old or prior lesions. Corticosteroids can also be used to treat new or worsening vertigo that is related to a new disease flare-up or lesion.

2. Speech Disorders

About 25 to 40 percent of people who have MS report having speech problems as a result of lesions or damage in different parts of the brain, according to the National Multiple Sclerosis Society (NMSS).

These symptoms, also known as dysarthria, tend to occur when you're further along in the course of your disease, and when you're very fatigued. Per the NMSS, speech disorders experienced by people who have MS include:

• Scanning speech or scanning dysarthria, where the normal "melody" or speech pattern is altered
• Slurring, which is typically due to weakness or a lack of coordination in the muscles of the tongue, lips, cheeks, and mouth
• Dysphonia or loss of speech volume, which can be due to a weak diaphragm
• Stuttering

If you're having speech problems due to MS, a speech or language pathologist can help, as can assistive devices such as smartphone apps .

How Can Someone Identify New or Worsening MS Symptoms?

MS can cause a broad variety of symptoms. Neurologist Mill Etienne, MD, MPH, lists some of the common ones that should prompt

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3. Difficulty Swallowing

You may experience difficulty swallowing (dysphagia) if you have MS, particularly in the later stages of the disease. This can happen when the nerves that control the muscles in the mouth and throat become damaged. It can also be a result of numbness of the mouth and throat, or mouth dryness due to medication.

Difficulty swallowing can be a serious problem, and it's important to seek diagnosis and treatment as soon as possible. A speech or language pathologist can teach you strategies and exercises for safer eating and swallowing, and help you make any necessary dietary changes.

4. Itching

Some people who have MS experience dysesthesia, or painful sensations in the legs, feet, arms, and hands. They typically feel like burning, prickling, stabbing, ice cold, or electrical sensations.

Pruritis (itching) is a form of dysesthesia. When you have MS, the nerves in the central nervous system that convey sensory information can be damaged. This damage can cause you to feel itchy even though you don't see any irritation. Because the cause is neurological and not physical like a bug bite or rash, topical skin creams won't help.

Treatment for this type of pain or itching may include anti-seizure medications and antidepressants, as well as acupuncture , mindfulness, meditation, and cognitive behavioral therapy (CBT).

Don't miss these real-life tips from hundreds of people who have MS. Go to Tippi MS and learn more.

5. Hearing Problems

About 6 percent of people who have MS report having impaired hearing, per the NMSS.

Rarely, hearing loss can occur as the first symptom of the disease. Hearing loss in MS can be linked to damaged nerve pathways in the brain and the brain stem. However, it's important to note that hearing loss in MS is very uncommon, and most acute episodes get better over time. Be sure to talk to your healthcare provider to determine what is causing your impaired hearing.

6. Tremors

Tremors , or uncontrollable or involuntary shaking, can occur in various body parts as a result of MS-related damage to the nerve pathways that coordinate movements.

The most common type of tremor (and most disabling) that occurs in MS is known as an intention tremor. It's usually most pronounced during physical movement, and gets worse as you try to grasp or reach for something, or move your hand or foot to a specific spot.

Tremor can make it challenging to perform daily activities like eating, drinking, and getting dressed, and can cause some people to feel embarrassed and to avoid social situations.

Your healthcare provider may prescribe different medications to treat tremor, but finding an effective treatment can be difficult. Occupational and physical therapists can help you find ways to manage tremor, including the use of assistive devices.

7. Headache and Migraine

While headache isn't considered a hallmark symptom of MS, research shows that the prevalence of migraine in people with MS is around 30 percent, which is higher than that of the general population. Previous studies have found that up to half of people with MS who experience headache have either cortical or brain stem lesions.

Still, the evidence of a link between MS and migraine is lacking and the conditions don't appear to have the same underlying causes. If you're being treated for both, it's important to know that interferon beta therapy for MS can increase the risk of headaches. When it comes to managing symptoms, regular exercise has been shown to reduce the severity and frequency of both MS relapses and migraine attacks.

8. Breathing Problems

Breathing problems can occur as a result of MS-related damage to the nerves that control the chest muscles. This issue can get worse over time, and be especially exhausting for those who already experience MS fatigue.

Breathing exercises can be helpful, but it's important to see a healthcare provider who specializes in breathing issues to ensure proper diagnosis and treatment.

9. Loss of or Change of Taste and Smell

Research has shown that many people who have MS experience changes in how food tastes and smells . Around 25 percent of people with MS have experiencing diminished taste, according to the NMSS. While this could be due to MS itself, it can also be caused by certain MS medications.

Olfaction, or sense of smell, is also affected by MS. Research shows that olfactory dysfunction is prevalent in about 27 percent of people with MS, significantly higher than the general population.

Before you assume that MS is the cause of impaired or decreased taste, get your symptoms checked out by your doctor, as new loss of taste and smell can also be a symptom of COVID-19, among other conditions.

The Takeaway

Multiple sclerosis (MS) isn't just about fatigue and mobility problems. You might also experience some surprising symptoms like vertigo, speech issues, or even changes in taste and smell. Always consult with your doctor if you notice any new or unusual symptoms popping up.

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Sources

1. Vertigo and Dizziness. National Multiple Sclerosis Society .
2. Speech Dysfunction. National Multiple Sclerosis Society .
3. Hearing Loss and Multiple Sclerosis. National Multiple Sclerosis Society .
4. Mirmosayyeb O et al. The prevalence of migraine in multiple sclerosis (MS): A systematic review and meta-analysis. Journal of Clinical Neuroscience . September 1, 2020.
5. Mirmosayyeb O et al. Olfactory dysfunction in patients with multiple sclerosis; A systematic review and meta-analysis. PLoS ONE . April 19, 2022.