Symptoms due to the nerves affected by demyelination

Special senses

Vision is almost always affected due to the involvement of the optic nerve.

Deafness also occurs in multiple sclerosis, occasionally at presentation.

Feelings of unsteadiness are common; and acute brainstem demyelination causes severe positional vertigo, vomiting, ataxia and headache.

Abnormalities of eye movement are common in multiple sclerosis, and often occur in the absence of symptoms

Motor symptoms and signs

Impaired mobility affects the majority of patients with multiple sclerosis, usually as a result of spinal disease; movements are generally slow. Spasticity may be more problematic than weakness, and all aspects of mobility are frequently complicated by fatigue. Cerebellar involvement causes inco-ordination of speech, eye movements and balance.

Sensory symptoms and signs

Altered sensation occurs at some stage in nearly every patient with multiple sclerosis, producing tight, burning, twisting or pulling sensations which are usually painful. Non-specific tingling, without any accompanying signs, is often described and the commonest physical sign found in the absence of symptoms is impaired vibration sense in the legs.

Amended April 2008