Private multiple sclerosis clinic in London, same-day specialist medicine.

Common early symptoms

• Optic neuritis — blurred or lost vision in one eye with pain on eye movement, often with colours looking washed out
• Numbness or tingling in a limb, the trunk or the face, lasting days to weeks
• Weakness or heaviness of a limb
• Unsteadiness, clumsiness or vertigo
• Double vision
• Lhermitte's sign — an electric-shock sensation down the spine on bending the neck forward
• Bladder urgency, and profound fatigue
• Symptoms typically develop over hours to days, persist for weeks, then improve — that pattern is characteristic

The types

• Relapsing-remitting — around 85% at diagnosis. Attacks followed by partial or complete recovery.
• Secondary progressive — gradual worsening developing after years of relapsing disease. Modern treatment appears to delay this.
• Primary progressive — around 10 to 15%. Gradual progression from the outset, without distinct relapses.

Treatment

• Disease-modifying therapies reduce relapse rate and new MRI lesions. There are now many, ranging from tablets to infusions, and current practice favours starting effective treatment early rather than escalating slowly.
• Relapses are treated with a short course of high-dose steroids, which speeds recovery but does not change the eventual outcome. Infection must be excluded first.
• Symptom treatment — for spasticity, bladder urgency, nerve pain, tremor and fatigue. Each has specific options and each is worth treating.
• Physiotherapy and exercise, which improve strength, balance, fatigue and mood, and are safe.
• Vitamin D supplementation is recommended.

Living with it