MS can be complex to manage due to the variability in symptoms between patients. Furthermore, many of the symptoms are ‘invisible’, that is, they are not 'visible' and therefore not necessarily fully appreciated by other people. Although each patient living with MS can experience their disease in different ways, the prevalence of some of the most common symptoms experienced in the first year after diagnosis are shown:
Data taken from the NARCOMS* registry a large natural history registry, a database that collects information from patient volunteers on patient-perceived impairment in 11 domains commonly affected in MS (n = 25728). The number of unique patient records is recorded below each symptom. Pain, depression, vision and tremor/coordination were not included in the survey until 2002.
*NARCOMS = North American Research Committee on Multiple Sclerosis
‘Invisibility’ of MS symptoms was found to have numerous impacts, including not feeling understood or validated by others, issues around the perceived legitimacy of the illness, and living with needs which are hidden. By considering the ‘invisible’ MS symptoms it can help to avoid them being unidentified, mislabelled or left untreated.
Approximately ~70% of patients living with MS will experience vision loss as a result of inflammation and demyelinating lesions in the optic nerve (leading to optic neuritis).
For example, current hypotheses into the pathophysiological mechanisms underlying primary fatigue in MS include:
Examples of a secondary cause of MS symptoms include urinary tract infections due to bladder dysfunction, or fatigue due to lack of sleep caused by MS symptoms like muscle spasms or bladder problems.