The following complaints occur regularly in the course of the disease:
Weakness of one or more limbs
Weakness may be experienced in one or more limbs. There may also be reduced dexterity (difficulty in performing manual tasks) and a lack of balance while walking. People with secondary progressive MS often suffer from a gradual loss of strength in the legs, frequently associated with muscular spasm (continual - often involuntary - contraction of the muscles).
A lack of feeling or an unusual feeling e.g. in both legs or hands, or in a single arm and/or leg. A tingling feeling ('pins and needles') or pain may also be felt in the affected areas.
Problems in coordinating the movements of the hands and legs often cause people with MS a lot of bother, especially because they are often associated with tremor (trembling) of the limbs affected. Coordination problems make it difficult to carry out smooth movements, such as picking up a cup and drinking from it. The MS Center Amsterdam offers regular group therapy sessions for people with balance problems.
Double vision is due to poor coordination of the contraction of the eye muscles; the person concerned thus loses the ability to direct the gaze automatically to the object of interest. Uncontrolled eye movements (nystagmus) are another common symptom of MS. They may cause the image seen by the patient to shift suddenly. The cause of double vision is generally located in the brainstem.
Speech disorders (dysarthria)
People with MS may have difficulty articulating their words and in speaking fluently. This might make them sound as if they were drunk. This complaint may be associated with difficulty in swallowing. It is important to report persistent difficulties in swallowing to the doctor, since they can lead to a form of pneumonia known as aspiration pneumonia.
Fatigue is a very common complaint in MS: about 70% of people with MS suffer from it. In fact, fatigue is often the symptom that bothers people with MS most in the early stages. The cause of the tiredness is not known: it is probably due to a combination of factors. Fatigue is not easy to treat. The MS Center Amsterdam has developed its own special approach to this problem.
The commonest bladder problems are incontinence, inability to empty the bladder fully or a combination of the two. Incontinence is due to oversensitivity of the bladder, which give rise to a strong urge to pass water even if the bladder is only partially full. Inability to empty the bladder is caused by involuntary contraction of the sphincter muscle. It can lead to bladder infections.
The most common sexual problems affecting men are erection disorders, difficulty in ejaculation or reaching orgasm and lack of sex drive (libido). Women suffer most commonly from reduced libido, difficulty in reaching orgasm and vaginal dryness. Sexual problems are encountered very often in MS. They may be a direct result of the disease, or may be caused indirectly - for example, by muscular spasm or fatigue.
Cognitive problems (in particular poor memory and inability to concentrate)
These complaints are also very common, even in the early stages of MS. It is not always easy to say whether they are caused by the MS or by psychological problems. Depression can lead to the same problems, for example. We have developed a special approach to the treatment of cognitive complaints at our Center.