12 Important (but lesser-known) MS Symptoms

Aug 27 2013

12 Important (but lesser-known) Multiple Sclerosis Symptoms:

1.  Lhermitte’s sign:  Pronounced “ler-meats.”  Electrical shock sensations down the spine when bending one’s neck forward.  Sign of cervical (neck) spinal cord attack.  New onset can be associated with numbness and weakness in arms and legs and can be treated with steroids in the vein.  Lhermitte’s is often an overlooked early symptom of MS.

2. Recurrent  sharp pain.  Electrical, burning or recurrent stabbing pain sometimes occurs with MS, especially on the head.  Severe bouts of pain lasting seconds to minutes from the ear to the jaw, cheek or forehead is known as trigeminal neuralgia.  Treatment options include gabapentin, oxycarbazepine, and topiramate for recurrent intense bouts of pain.  Surgical options include burning the nerve with radiofrequency ablation.

3.  Decreased color vision.   Often associated optic neuritis, an MS attack of the optic nerve connecting the eyeball to the brain.   Bright red colors seem faded or washed out compared to the normal eye.  Optic neuritis can also be associated with loss of central vision, blurred vision, and pain with eye movements.   Steroids through the vein would be the treatment of choice if significant visual loss.

4.  Bowel urgency.  While constipation is common in MS, some people have little warning when having to have a bowel movement.   This problem can be distressing, especially if associated with bowel accidents.  Some meds that work on bladder sphincters such as Enablex can work for the bowel urgency.  Other people have trouble evacuating their bowels and may benefit from suppositories.

5. MS Hug.  Squeezing sensation wraps around the torso from back to chest or abdomen. Due to an attack in the thoracic spinal cord.  New onset?  IV steroids might be considered.  Gabapentin, Cymbalta, and baclofen are possible medications that might provide relief.

6.  Hearing loss.   Uncommonly, the first symptom of MS.  Usually one side is affected and can be associated with spinning sensation, facial numbness and imbalance.    Best treated early with steroids in vein.

7.  Flexor spasms.  Intense spells of involuntary arm and leg muscle tightening.  The arms tend to curl up with the elbow bent and the hands clenched.  The spells usually last 30 seconds to 1 minute without loss of consciousness.  Often very painful.   Treatments options include baclofen, tizandine, oxcarbazepine, and gabapentin.

8.  Multitasking problems.   Many people with MS have problems with juggling multiple tasks at the same time.  Due to slowed thinking processing speed.   Best to minimize distractions when focused on a challenging problem.   Workplace accommodations such as location of desk in a busy office can be very useful.  Organization is key: smartphones, emails,  folders, and lists.

9.  Sexual dysfunction.  Sometimes MS causes trouble achieving orgasm due to a lack of sensitivity.  Men can develop erectile dysfunction.   A new change can be treated with steroids as a relapse.  For decreased sensitivity, sexual aids may be useful.  Men frequently respond well to the erectile dysfunction medications.  Some anti-depressants can prevent orgasm.

10.  Clonus.  Ever rest your foot on the ground and the foot starts to bounce up and down repetitively on its own?  Clonus is an increase in reflexes that is seen commonly in people with significant stiffness or spasticity in the legs due to MS.  Does not need to be treated since resolves when foot is moved.

11.  Leg cramps.   Due to spasticity, MS can cause uncomfortable or painful cramps in the legs.   Usually this occurs during the night. A muscle relaxant such as baclofen or tizandine at bedtime can help if a regular problem.   These meds can be taken during the day  if tolerated without drowsiness.

12. Decreased smell.  Fortunately uncommon so other causes should be investigated with your neurologist.

Note:  Some of the specific treatments including medications listed above may be off-label uses and not FDA-approved for this specific condition.  Always consult with your healthcare provider with symptoms to be fully evaluated for above conditions or alternative causes.   Take only treatments prescribed per your healthcare providers.





BY: Barry Singer, MD DATE: August 27, 2013 TOPIC: MS Research News