Extreme fatigue, clumsiness, weird prickly sensations, sluggish thinking, wonky vision — these are classic and common first symptoms of multiple sclerosis, or MS. But the expected stops here. Damage to the central nervous system, aka your brain and spinal cord, is what causes these symptoms. That’s a wide range of functions that affect many different people. So it can show up in some strange and varied ways.
Trapped in a Bear Hug
It’s not a warm and cozy kind of hug. Called banding, this MS symptom feels like something’s squeezing you firmly about the chest and won’t let go. It can strike anywhere between your waist and neck, or just on one side. You might have pain or breathlessness. It happens when damage from the disease blocks or garbles the messages from your nerves. Spasms in the muscles between your ribs trigger the tightness. It often passes on its own.
Out-of-Control Laughing or Sobbing
Pseudobulbar affect, also called PBA or emotional incontinence, prompts random outbursts of tears or laughter that have nothing to do with how you feel. Nerve damage in the part of your brain that controls emotions can cause your responses to get all mixed up. You might worry about it happening when you’re in public, or in a serious setting. The FDA has approved a drug to treat PBA. Antidepressants can help, too.
An Itch You Can’t Scratch
It’s the itch that isn’t. A sudden, intense tingle crops up out of the blue, anywhere on your body. But there’s no skin irritation or allergy to scratch or apply rash cream to. This kind of itch doesn’t stem from your skin. Dysesthetic itching is a nerve-related sensation that passes quickly. It’s treatable with meds for epilepsy. Carbamazepine (Carbatrol, Epitol, Equetro, Tegretol, Tegretol-XR), gabapentin (Horizant, Neurontin), and phenytoin (Dilantin, Phenytek) are a few.
Shocking Face Flashes
Nerve damage can trigger trigeminal neuralgia, a burning, stabbing, or shock-like pain in your cheek or jaw. It might fade fast or linger for a few minutes. Though rare, it can be a first symptom of MS. You might feel it come on as a tingle, numbness, or ache on one side of your face, like dental pain. Anticonvulsant meds such as carbamazepine, lamotrigine (Lamictal), or oxcarbazepine (Oxteller XR, Trileptal) can help.
Fiery Feet
Dysesthesia is an unpleasant “altered” sensation like burning, prickly pins-and-needles, numbness, and creepy-crawlies in any part of your body. For example, your feet might suddenly feel scalded, with no heat source — or damage — at all. Your brain gets distorted nerve signals, so it struggles to relate to something it recalls or imagines. Sometimes it comes up with some pretty crazy stuff. You can treat the weird feelings with nerve pain meds.
Hard to Swallow
Swallowing isn’t as simple as it seems. The nerves and muscles in your mouth and throat must work with your brain. With MS, the muscles you need to do it can weaken. Mixed-up nerve signals and sensory distortions can make it hard to chew or control the food or liquid in your mouth. Or you might feel there’s something stuck in your throat when there isn’t. It usually happens at a later stage of MS, but it can show up earlier, too.
Spine-Tingling Shock
Lhermitte’s sign is really a symptom. It’s a sudden “electric” zap that shoots down your spine and legs. It happens usually when you flex your neck forward, as when you get your hair trimmed. (Another name for it is the barber chair sign.) Lesions in the cervical spine — your neck area — cause it. Lhermitte’s goes away as quickly as it comes, so it typically doesn’t need treatment.
Blurred Vision
Damage to the optic nerve (optic neuritis), which links your eye to your brain, can trigger something called Uhthoff’s phenomenon. This means your vision briefly goes blurry when your body temp rises. (Your other MS symptoms may get worse, too.) Exercise, hot baths, warm weather — even hair dryers — can all make eye-to-brain signals iffier than usual. It can help to take a cool shower, use a gel pack, and drink lots of cold water before you exercise or go out in the heat.
Optical Illusions
Another optical trick MS can play is the Pulfrich phenomenon. Optic neuritis triggers this one too. It’s a 3-D illusion caused by a conflict in your vision. Let’s say an object is headed toward you in a straight line. Instead, you might see its path as an elliptical orbit. An oncoming car might appear to swerve toward you, or you’ll miss a ball as you try to catch it. A special filter in front of one eye can help balance your vision.
Sudden Spasms
Abrupt, brief spasms called paroxysms happen when electrical discharges fire in damaged areas of your brain. They might surge through your arm or leg, or the muscles you use to eat and speak. Although they can repeat several to many times a day, the bout usually ends within a few months. While scary, they’re not the same as seizures. You can treat them with antiepileptic meds, such as carbamazepine, lamotrigine, or oxcarbazepine.
Migraines
Migraines are sudden headaches that can last from several hours to days. They can sometimes be the first MS symptom. People with MS are twice as likely to have them. They can bring on nausea or make you sensitive to sound and light. This can keep you from your regular activities. People with MS seem to have family histories of migraine, so researchers are looking for a link.
Hearing Problems
What’s that you say? Rarely, hearing problems can be a first symptom of MS. It might have a link to swelling and scar tissue near your auditory nerve, which carries info to your brain. Plaque buildup on the nerves along this pathway can lead to it, too. These episodes usually improve, and permanent deafness is rare.
Vertigo
If you have vertigo, you may feel like you — or the area around you — is spinning. It can throw off your balance way more than just dizziness. You might also feel lightheaded or queasy from the sense of motion. It happens to about 1 in 5 people with MS. It can stem from damage in the same pathways that control your hearing and vision. Treatment can include physiotherapy, which studies how your movements affect it.