What is Spinal MS?

Maybe you have heard the term “Spinal MS.” What is that? I thought MS could be relapsing, primary progressive, secondary progressive, or “benign.”

The lesions caused by multiple sclerosis can occur anywhere within the central nervous system, which includes the brain, the spinal cord, and the optic nerves. Approximately 55-75 percent of patients with MS will have spinal cord lesions at some time during the course of their disease. If a patient does have lesions in the spinal cord, he/she may be said to have Spinal MS.

A smaller number of MS patients, approximately 20 percent, may have only spinal lesions and not brain lesions. I am an example of one of those 20 percent of MS patients who only have spinal lesions.

Symptoms of Spinal MS

Spinal MS occurs more commonly with lesions in the cervical spine (the neck area) in approximately 67 percent of cases. Lesions in this area often affect the corticospinal tract. Neurological signs which indicate lesions in the corticospinal tract include the Babinski Sign and the Hoffmann Sign. Additional indicators of lesions in the upper spine include the l’Hermittes phenomenon and the Romberg Sign. At one time or another, I have shown each of these signs of neurological involvement/interference due to MS lesions.

Although the location of lesions do not always closely correlate to areas of clinical disability, there are cause/effect patterns which do emerge. Patients with spinal cord lesions are more likely to develop bladder dysfunction (e.g., urinary urgency or hesitancy, partial retention of urine, mild urinary incontinence), bowel dysfunction (e.g., constipation or urgency), and sexual dysfunction (e.g., erectile dysfunction or impotence in men, genital anesthesia or numbness in women, pain with intercourse for either sex). Complete loss of bladder and bowel control may be lost in more advanced cases of MS.


Spinal cord lesions can also lead to sensory and motor deficits, including dysesthesias, spasticity, limb weakness, ataxia or other gait disturbances.

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What is Spinal MS?

Common Multiple Sclerosis Symptoms

Multiple sclerosis is a disease of the central nervous system (CNS) with symptoms that can affect almost anything from head to toes. The disease is so variable that no two people with MS are likely to have exactly the same combination of symptoms. As MS symptoms mimic dozens of other conditions, it is also important to consider that this list is not exclusive to MS.

Here are 50 of the most common MS symptoms:

Sensory problems

• Abnormal sensations (dysesthesias)
• Numbness, tingling, burning, or tightness
• Pins and needles
• Severe itchiness (pruritus)
• Hypersensitivity to touch
• Pain - acute or chronic, mild to severe
• Loss of proprioception (sense of body position in space)
• Inability to detect vibrations
• Impaired sense of taste or smell
• Trigeminal neuralgia - stabbing pain in the face
• L’Hermitte’s sign - electrical shock-like sensation running down the spine and into the limbs when you bend your neck forward or backward
• The MS hug

Motor problems

• Loss of strength or muscle weakness
• Loss of muscle tone (hypotonicity) or increased muscle tone (hypertonicity)
• Spasticity - continuously contracted muscles and/or muscle spasms
• Myoclonus - sudden involuntary muscle contractions
• Tremor
• Foot drop
• Problems walking, impaired gait, or mobility problems
• Paralysis
• Loss of balance
• Loss of coordination (ataxia)

For more MS symptoms, read this post in its entirety:

Top 50 MS Symptoms

Marcus Gunn Syndrome and Multiple Sclerosis

One test which my neurologist, ophthalmologist, and primary care doctor each conduct during every office visit is the “swinging flashlight test.” You know the one. The doctor asks you to look ahead then shines a penlight first toward one eye, then the other, alternating quickly to observe your pupils’ response to light.

I strangely enjoy this test because I know that my pupils will show something unique. Something which proves that I have damage to my optic nerve. My pupils show a Relative Afferent Pupillary Defect (RAPD) or Marcus Gunn Sign.

What does the doctor look for during the “swinging light test”?

The pupils (the black centers of the eyes which dilate or constrict in response to light) are inspected for size, equality, and regularity. Did you know that the pupils will constrict or dilate when you look at objects far or near? They do, which is kinda cool.

More importantly, each pupil should constrict quickly and equally during exposure to direct light and to light directed at the other pupil (the consensual light reflex). Using the swinging light test, the doctor can test and observe the pupillary response to consensual light in order to determine if there is a defect present.

Normally, the pupil constriction does not change as the light is swung from eye to eye. When the light is moved quickly from eye to eye, both pupils should hold their degree of constriction.

What is a Relative Afferent Pupillary Defect?

The Afferent Pupillary Defect (APD) or Relative Afferent Pupillary Defect (RAPD) is an abnormal and unequal response in the pupils of the eyes when exposed to light. It basically demonstrates that one optic nerve transmits a different message to the brain than the other one. Testing for RAPD is a good way to implicate or rule out optic nerve damage such as is caused by optic neuritis.


My temporarily blinding case of optic neuritis in 2000 left my right eye impaired. It doesn’t register light in the same way as my left eye as the optic nerve has permanent damage. When the doctor shines the light in my left eye (the “good” eye), both pupils will constrict. This is normal. When the doctor quickly moves the light to my right eye (the “bad” eye), my pupils begin to dilate since the brain thinks that less light is coming in. This shows that there is damage to the corresponding optic nerve.

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MS Signs and Symptoms: What is Marcus Gunn Syndrome?

Nystagmus and Multiple Sclerosis

Nystagmus is a condition that causes the eyes to make quick, repetitive, uncontrolled movements — from side to side, up and down, or in a circular pattern — making the eyes appear to bounce around. The jerky motion may be triggered by optical stimuli or physical motion, or may occur at rest.

Nystagmus can be mild, occurring only when a person looks to the side, or it may be severe enough to impair vision. Nystagmus often makes it difficult to focus steadily on a fixed object.

What causes nystagmus?

Nystagmus can be an inherited condition, showing up in early childhood, or it can develop later in life due to an accident or illness. Nystagmus is often a symptom of an underlying medical problem, such as stroke, multiple sclerosis, or head trauma. Other causes of nystagmus include severe nearsightedness, albinism, inflammation of the inner ear, central nervous system diseases, and medication side-effects. Sometimes the cause may be unknown.


In persons with multiple sclerosis, lesions in the brainstem and cerebellum may interfere with the nerve signals that affect motion of the eyes causing nystagmus. According to the MS Foundation, approximately 35 percent of individuals with multiple sclerosis may develop nystagmus. Abnormal gaze-holding mechanisms, vestibular imbalance, and impaired fixation are the most common causes of nystagmus in multiple sclerosis.

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MS Signs and Symptoms: What is Nystagmus?

MS Pain: What is the MS Hug?

Pain is not a symptom of multiple sclerosis, right? Wrong. That has got to be one of the more frustrating myths for those of us living with MS. Pain in MS can show up as neuropathic pain or musculoskeletal pain. A particularly disturbing type of pain in MS that can sometimes feel like a boa constrictor is squeezing the breath out of you has commonly been called the MS hug.

Neuropathic pain

Symptoms of MS stem from damaged myelin (the coating that protects nerves) that impacts proper nerve function and health. Neuropathic pain can be caused by disrupted nerve signals. Symptoms of neuropathic pain may include abnormal sensations — tingling, numbness, skin crawling, itching, burning, or prickly sensations — which are called paresthesias. These can be acute or chronic, severe or mild, painful or just plain weird.

Musculoskeletal pain

In MS, disrupted nerve signals and overly sensitive motor neurons can lead to spasticity and/or painful muscle spams. Musculoskeletal pain caused by muscle spams, muscle weakness, physical stress on joints, or poor coordination are commonly associated with MS. These pains may be acute or chronic. When they show up suddenly, last only a brief period of time, and disappear rapidly, they are called paroxysmal symptoms. Paroxysmal symptoms may occur once or repeat over a longer period of time. If they show up repeatedly, that might be a sign of an MS relapse.

Treatment for MS pain

Common pharmacological management of neuropathic pain in MS includes anti-seizure drugs, corticosteroids, anti-spasticity drugs, or benzodiazepines. Antidepressant agents and opioids may help to modulate the experience of pain. Musculoskeletal pain may respond to physical therapy, stretching, spasticity medications, and conventional painkillers such as ibuprofen.

The MS hug: Definition and causes

The MS hug is a highly unpleasant, painful banding sensation that occurs anywhere around the torso. Some people in the online community have referred to the MS hug as the “Squeeze o’ Death.” Symptoms of the MS hug can show up anywhere on the torso, on one side or the other, or circling all the way around the body. The pain can range from mild numbness or tingling to excruciatingly sharp pain or pressure. Each person’s experience is unique and may even differ from one episode to the next.

Explanations of the cause of the MS hug vary. The pain may be neuropathic in origin such as dysesthesia (which is basically a really bad paresthesia). The pain might stem from extreme spasticity in the intercostal muscles of the rib cage. There are three layers of muscle fibers in the intercostal muscles that connect the ribs and assist with breathing. If these muscles are involved, symptoms may include chest tightening, difficulty breathing, and limited mobility.

What to do if you have the MS hug

If you suddenly experience chest pain or asthma-like symptoms, or you feel like a big snake is trying to squeeze the life out of you, don’t assume that it is your MS. Seek medical attention immediately. There may be another cause of your symptoms or pain. It’s better to err on the side of caution when your health is concerned......

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What is the MS Hug?

Why Does the Neurologist Tap My Finger?

The neurologist is looking to see if there is a finger flexor response.  The finger flexor response is demonstrated by a sudden flexing of the thumb and/or index finger.  There are two ways to cause this response:

• The doctor snaps or flicks the nail of the middle or 4th finger.  A positive finger flexor response elicited in this manner is known as the Hoffmann reflex or sign.
  
• The doctor holds the middle finger while partially flexing it between his/her finger and thumb, then taps or flicks the underside of that finger.  A positive finger flexor response elicited in this manner is known as the Trömner sign.
  

What causes the thumb to flex?

The finger flexor response (Hoffmann relex or Trömner sign) is somewhat similar to the Babinski sign in that it is suggestive of a lesion or impingement along the corticospinal tract.

What is the corticospinal tract?

Very long nerve axons which originate in the part of the brain called the cerebral cortex travel through the brainstem, cross over at the top of the cervical spine and travel down each side of the spinal cord. This path is the corticospinal tract which is sometimes called the pyramidal tract since the area where the crossover of nerves occurs has a pyramid-like shape.

Corticospinal tract neurons are referred to as “upper motor neurons” but they do not control muscles directly. Neurons in the ventral horn that directly innervate (or stimulate) muscle are called lower motor neurons.  It is damage in lower motor neurons which causes atrophy of muscle, while damage in upper motor neurons does not.

How do the Hoffmann or Trömner signs differ from the Babinski sign?

Each of these signs indicate damage in the corticospinal tract. The Babinski sign indicates damage anywhere along the corticospinal tract. However, the Hoffman and Trömner signs are a bit more specific in that they indicate a lesion or damage above the C5 or C6 level of the cervical spine.

Read this post in its entirety:

MS Signs and Symptoms: What is the Hoffmann Reflex?

2017 Top HealthCentral Multiple Sclerosis Posts

From personal stories, embarrassing stories, and inspirational stories to research news, bizarre symptoms, and talks of life changes due to MS, we covered a little of everything in 2017.

Life changes with MS

A chronic condition like MS may mean not being able to enjoy the things you did before diagnosis — but it can also result in new pursuits and pleasures.

Read about the 3 things Lisa misses most about life before multiple sclerosis.

Life is created from memorable moments

MS Moments: Urinary Incontinence in the Street

Urinary incontinence is an embarrassing symptom of multiple sclerosis that can occur at the most inopportune moments.

Fear of Change: A Relapsing MS Moment

Handling the ups and downs of multiple sclerosis takes practice, patience, and persistence.

Celebrating caregivers

My Husband, My Caregiver

Caregiving takes practice when MS is a third wheel in the relationship.

A Balancing Act: Being a Caregiver for a Wife With MS

In 1992, Liz Hoy was diagnosed with MS. Since then, her husband Mike has cared for her and been a tireless advocate on her behalf.

Being a Caregiver When You Have a Chronic Illness

It’s necessary to focus on self-care before you can care for a loved one in crisis.

Answering important questions

Weakness, Numbness, and Tingling in My Hands: Is it MS or Carpal Tunnel Syndrome?

Distinguishing between the symptoms of multiple sclerosis and those of other conditions can be difficult at times.

Is Gut Bacteria Associated With MS?

The gut microbiome is a hot research topic these days. Some studies suggest that gut health might be associated with multiple sclerosis.

So how are you really doing?

The many shades of “I’m Fine.”

When you’re living with a chronic condition, it’s not always easy to answer when people ask, “How are you?”

Focusing on mental health may help you to clean out the emotional clutter of MS.

Exercise to improve MS symptoms

Benefits of Tai Chi for Multiple Sclerosis

Tai Chi, a mindfulness-based exercise program, has been studied in clinical trials to determine if it improves multiple sclerosis symptoms.

What is Vestibular Rehabilitation Therapy?

Vestibular rehabilitation therapy is an exercise-based treatment program designed to improve your brain’s ability to adapt to vestibular problems and to use other senses to compensate for deficiencies.

Be more than your MS

Shining in a Glamorous World

Lacy Gadegaard, founder and owner of Laced Hair Extensions, gets candid about how being diagnosed with multiple sclerosis saved her life.

How Does Personality Affect Cognition in MS?

Personality traits, such as openness to new experiences, may help to protect memory function and cognition in people living with MS.

Maintain access to accessible parking

Accessible parking is one of the more controversial issues in the MS community. Many people have mixed feeling about the need to park in spaces that offer increased access.

So, why should you get a disabled parking placard?

Once you have your placard, be sure to park within the lines of the designated spaces. Others need to park there too.

Here’s how NOT to park in the accessible parking space.

Facing common symptoms of MS

A Wintry Mix: The Effect of Cold Temperatures on MS Symptoms

While some people with multiple sclerosis are heat intolerant and have trouble during the summer, others are sensitive to cold temperatures.

What Can Cause Dizziness in MS?

Dizziness associated with multiple sclerosis is about more than vertigo or loss of balance.

Why Does MS Make My Legs Hurt?

Pain in MS comes in many forms — neuropathic pain, musculoskeletal pain, spasticity, and spasms; each can make your legs hurt.

And less common MS symptoms

MS and My Bloodhound Nose

Hyperosmia, an increased sense of smell, is one of those weird MS things I’ve learned to live with.

MS Signs and Symptoms: Loss of Taste or Hypogeusia

Smell and taste are closely related, but an altered sense of taste may signal MS progression.

MS Signs and Symptoms: What is Trigeminal Neuralgia?

Trigeminal neuralgia (TN) is a symptom of multiple sclerosis that causes intense pain in the face and jaw.

Welcoming 2018

As we look forward to 2018, we invite you to live BOLD, live NOW, and be empowered to take control of your health. Please join us in our MS HealthCentral Facebook community and follow us on Twitter @MSHealthCentral.

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HealthCentral Top Multiple Sclerosis Posts of 2017 

Remembering Life Before MS: What I Miss Most

My multiple sclerosis diagnosis took multiple years. It wasn’t a quick affair. Years separated early attacks, including five years between a case of temporary blindness from optic neuritis and the loss of the use of my left hand and arm which finally led to a diagnosis. During those years, my life was evolving as well.

Before MS, I was actively building a career as a freelance musician in the Washington, D.C., area. At one point, I was teaching a weekly schedule of 44 private students while also performing in at least two or three concerts each month. The demand upon my time and energy was tremendous.

Since MS, I have become a wife, writer, patient advocate, speaker, consultant, moderator, medical reviewer, and new Bike MS participant. I will always be a musician and still teach private lessons in my home studio. My schedule is just as busy as before, although I am engaged in different activities.

What I miss most:

Chest-thumping sounds

I miss the tremendous sensation of the sound waves produced by 100 other musicians on a symphony stage traveling through my body during a performance. The joy of listening to perfect harmony and stylistic precision up close and personal. The mix of overtones in the ears that stimulate the brain in a most satisfying way. There is nothing quite like it.

Now, I have difficulty with sudden sounds that feel like an ice pick to the brain.

Separation of work and home

I miss that satisfying feeling of coming home after a long day of lessons and/or rehearsals to take my shoes off, sit on the couch, and chill with some late night television. With clearly defined boundaries, both physical and mental, of what is work and what is not work, it is nice to feel the separation between activities.

Now, I work from home. As a writer and community moderator, I can be “at work” 24 hours a day, anytime of the day. I find myself with my laptop computer in my recliner toggling between projects for hours at a time. And with the potential cognitive problems associated with MS, it becomes difficult to stay focused on any one project.

Hiking and crunching leaves

As a graduate student, I lived not far from beautiful Brown County State Park in Indiana. Hiking was particularly fun during the autumn, when leaves of many colors covered the ground. The combined sound of rustling leaves in the trees and boots sweeping through blankets of leaves on the trail was particularly satisfying on a cool, crisp morning.

Now, I need to be able to see any obstacles on the ground or risk catching my toes on the tiniest of surface imperfections. Tripping on air has become one of my special talents since living with MS has impacted sensation in my feet. Walking on any path that is covered with leaves, stones, or debris poses an extreme tripping hazard.

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Three Things I Miss Most About Life Before MS

MS Symptoms May Aggravate Osteoarthritis

Although osteoarthritis (OA) is generally considered to be a “wear and tear” condition affecting older adults, it can also affect individuals in their 40s and 50s. I was first diagnosed with knee osteoarthritis in my early 40s, several years after being diagnosed with MS in my mid-30s. My case of OA is tricompartmental, meaning that it affects each of three joint areas where the thigh bone and lower leg come together and behind the kneecap. Eventually I will need total knee replacement on both my left and right knees.

Do MS symptoms lead to osteoarthritis?

One of the more complex risk factors for knee OA is muscle weakness, particularly in the quadriceps. MS can be associated with weak thigh muscles. Researchers examining potential associations between MS and osteoarthritis hypothesized that the knee joint in people with MS might be more greatly affected due to problems with balance and muscle weakness and may result in earlier joint degeneration.

To test this theory, researchers used ultrasound to investigate whether there is a correlation between the breakdown of femoral cartilage — the cartilage that covers the end of the thigh bone — and MS-related disease parameters.

Read this post in its entirety:
Are Multiple Sclerosis and Osteoarthritis Connected?

Sex and MS: Speak Up! Your Doctor May Not Ask

During a routine visit with your neurologist, there is much material to cover. Your doctor will ask about symptoms, watch you walk, and conduct a neurological exam. He or she may also ask about your family life, work life, relapses, or treatment concerns. However, it turns out that many doctors may be uncomfortable asking about your sex life.

In a survey of 42 neurologists, members of the Consortium of Multiple Sclerosis Centers, more than 80 percent of respondents report routinely assessing for depression, anxiety, sleep, and pain—but only half ask about sexual dysfunction; 18 did not routinely assess sexual function; 24 did.

Multiple sclerosis (MS) can affect sexual function in women and men with MS, thus impacting quality of life. Symptoms of sexual dysfunction can include sensory changes, decreased lubrication, erectile dysfunction, decreased libido, or problems with orgasm. In some patients, spinal cord lesions can be associated with bladder, bowel, and/or sexual dysfunction.

Sexual dysfunction (SD) is a common symptom of MS that may be under-diagnosed, particularly in women with the disease. A survey of 86 women with relapsing-remitting MS revealed that 27 percent of respondents experienced SD. Persons with other forms of the disease may be more likely to have sexual dysfunction.

Read this post in its entirety:
Why You Should Talk To Your Doctor About Your Sex Life

Using Tai Chi To Help MS Symptoms

Tai Chi, also called Tai Chi Chuan, is an ancient Chinese martial art that has evolved into a multiple-element form of exercise, featuring slow, gentle, dance-like movements that encourage deep breathing and relaxation, improve balance, and strengthen muscles and joints. I’ve heard Tai Chi referred to as “meditation in motion.” One benefit of Tai Chi is that is doesn’t require any special clothing or equipment. It is one of the mind-body therapies in complementary and alternative medicine that begins where you are and doesn’t push you beyond your abilities, but does encourage you to explore the edges of your comfort zones.

How does Tai Chi help MS?

Several studies have examined the effect of Tai Chi on different aspects of living with MS and its symptoms. In a systematic review of the literature, researchers found evidence that supports the effectiveness of Tai Chi on improving quality of life and functional balance in people living with MS patients. A small number of studies also reported the positive effect of Tai Chi on flexibility, leg strength, gait, and pain. The effect of Tai Chi on fatigue, however, is inconsistent across studies.

Tai Chi and quality of life in MS

Quality of life (QOL) is a helpful measurement in MS studies because it encompasses physical, material, social, and emotional well-being, as well as personal development and physical and social activity. Five studies examining the effect of Tai Chi on QOL in MS were included in this systematic review. In general, MS patients who engaged in Tai Chi sessions over three- to twelve-week time periods experienced significant improvements on subscales of QOL such as pain, emotional well-being, energy, vitality, social function, health distress, physical health, mental health, and overall QOL.

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Benefits of Tai Chi for Multiple Sclerosis

What is Trigeminal Neuralgia?

A sharp pain explodes through your face and jaw. You think that perhaps an invisible bolt of lightning just struck without any warning. You’re not sure what happened, but you do know that you don’t want it ever to happen again. You may have experienced your first acute attack of trigeminal neuralgia.

Trigeminal neuralgia (TN), also known as the tic douloureux, prosopalgia, the “suicide disease,” and Fothergill’s disease, is a facial pain disorder characterized by brief electric shock-like pains that can occur abruptly, typically on only one side of the face and along one or more of the three branches of the trigeminal nerve. The trigeminal nerve, which is the fifth cranial nerve, is responsible for sensation in the face and motor function controlling the jaw.

The stabbing pain of TN most often affects the right side of the face. Frequency of attacks can range from one per day to 12 or more per hour. Common triggers of TN include chewing, talking, or smiling; drinking cold or hot fluids; touching, shaving, brushing your teeth, or blowing your nose; or sudden contact with cold air.

An individual can often point out exactly where the pain of TN is felt. In the majority of cases, the pain shoots from the corner of the mouth to the back of the jaw. In fewer cases, the pain spreads from the upper lip or teeth up to and around the eye and eyebrow.

There are two patterns of pain in trigeminal neuralgia. The first pattern is episodic and affects more than 50 percent of patients. The second pattern features constant pain, the mechanisms and development of which are not well understood. In episodic cases, the intensity of the pain typically increases from simply being present to an excruciating pain felt deep in the face in less than 20 seconds. Muscle spasms may accompany the pain.

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MS Signs and Symptoms: What is Trigeminal Neuralgia?

Does Personality Affect Cognition in People with Multiple Sclerosis?

Multiple sclerosis (MS) is a chronic disease that frequently leads to neurological symptoms and disabilities. The effects of MS can result in sensory changes, vision problems, mobility challenges, impaired control over bodily functions, cognitive dysfunction, and altered moods.

The cognitive challenges of MS, while quite common, can be particularly disturbing. More than half of all people with MS will develop problems with cognition, according to the National MS Society. Certain types of cognitive functions are more likely to be affected by MS than others, for example:

• Information processing (dealing with information gathered by the five senses)
• Memory (acquiring, retaining, and retrieving new information)
• Attention and concentration (particularly divided attention)
• Executive functions (planning and prioritizing)
• Visuospatial functions (visual perception and constructional abilities)
• Verbal fluency (word-finding)

Read this post in its entirety:
How Does Personality Affect Cognitive in MS?

MS Diagnosed As Carpal Tunnel Syndrome

Distinguishing between the symptoms of multiple sclerosis (MS) and those of other conditions can be difficult at times. One year after I was diagnosed with MS, I began to experience problems with both of my hands. They became clumsy, painful, stiff, tingly, and numb, while my forearms were painful. I initially suspected MS because symptoms that had led to my eventual MS diagnosis included weakness and numbness in my left arm, hand, and last two fingers.

But this presumed MS attack was somewhat different. It affected both hands and caused pain in my fingertips that made touching anything — like piano keys or a computer keyboard — excruciatingly painful. I was dropping things and couldn’t continue to do the things I loved and needed to do.

My neurologist examined me carefully. He checked my strength, coordination, and reflexes. He flicked my middle fingernails looking for the Hoffmann reflex. He tapped the area over my wrists (Tinel’s test) and had me hold my hands in a reverse prayer position (Phalen) to see if either maneuver elicited additional tingling or numbness in my fingers. None of these tests are definitive, but they can be helpful in diagnosing carpal tunnel syndrome (CTS).

Read this post in its entirety:
Weakness, Numbness, and Tingling in My Hands: Is It MS or Carpal Tunnel Syndrome?

Dizziness and Multiple Sclerosis

Being diagnosed with multiple sclerosis (MS) is enough to make your head spin. The amount of information available regarding MS and its symptoms is downright dizzying. But MS doesn’t just figuratively turn your world topsy-turvy, it can literally make things unsteady and disorienting.

Dizziness is a common symptom that affects approximately 20 to 30 percent of people in the general population. The term dizziness is a bit vague, but it basically means a feeling of disequilibrium. One particular subtype of dizziness that can affect people with MS is vertigo — a sensation that you or the world around you is spinning or balanced on a tilted axis.

Central vertigo, caused by disease of or damage to the central nervous system, is responsible for almost one-fourth of cases of dizziness reported by all patients. The most common central causes of dizziness and vertigo are cerebrovascular disorders related to blood circulation in the brain, migraine, multiple sclerosis, tumors in the brain stem or cerebellum, neurodegenerative disorders, some medications, and psychiatric disorders.

Dizziness in MS may be caused by nystagmus, eye movement disorders, vestibular problems, or lesions on certain parts of the brain or cranial nerves. According to a 2013 study published in the journal Multiple Sclerosis and Related Disorders, dizziness affects more than 70 percent of people with MS. Prior studies suggested that dizziness affects 49 to 59 percent of people with MS.

Read this post in its entirety:
What Can Cause Dizziness in MS?

Why Do My Legs Hurt?

People living with MS can experience different types of pain in the limbs (legs or arms), the most common of which are neuropathic or musculoskeletal in origin. Neuropathic pain in MS is frequently caused by lesions in the spinal cord and is characterized by sensory changes. Spinal cord lesions may also cause muscle weakness, spasticity, ataxia, or other gait disturbances, each of which can lead to musculoskeletal problems.

Do you experience burning, itching, numbness, tingling, stabbing, or the sensation of bug bites in your legs? These are examples of paresthesia, a form of neuropathic pain, and are often experienced by people with MS. A particularly strange sensation is the feeling of water dripping on or down the leg, which is an example of dysesthesia. Other dysesthesias involve the abnormal interpretation of sensation, hypersensitivity to touch, or a tight banding sensation.

Neuropathic pain and sensory changes are often treated with anti-seizure medications, such as gabapentin, pregabalin, carbamazepine, tizanidine, or clonazepam, and certain antidepressants.

For me, spasticity is a significant source of musculoskeletal pain in the legs. Other causes of MS-related musculoskeletal pain include poor posture, inefficient walking (gait), physical inactivity, muscle deconditioning (being out of shape), and muscle fatigue or weakness.

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Why Does MS Make My Legs Hurt?

What is optic neuritis?

Optic neuritis (ON) is an inflammation of the optic nerve, a bundle of fibers that transmits visual information from your eye to your brain. Symptoms of ON are varied, often including pain behind the eye and different degrees of vision loss. People with ON may experience blurry vision, blind spots, a graying out of vision, or dull colors. ON can, but does not always, result in temporary blindness and usually affects only one eye at a time. ON may be accompanied by flashes of light or new floaters which should be reported to your eye doctor and/or neurologist.

What causes optic neuritis?

Common causes of optic neuritis include demyelinating diseases, such as multiple sclerosis (MS) or neuromyelitis optica spectrum disorder (NMOSD, formerly known as neuromyelitis optica or Devic’s disease). In MS and NMOSD, the immune system attacks the myelin surrounding nerve fibers of the brain, optic nerves, or spinal cord resulting in inflammation and/or lesions that disrupt nerve signals to and from the brain. If NMOSD is suspected, a blood test can help distinguish it from MS and facilitate diagnosis.

Other causes of optic neuritis may include bacterial or viral infections (e.g., Lyme disease, cat-scratch fever, syphilis, measles, mumps, herpes), other autoimmune diseases (e.g., sarcoidosis, lupus), or drug side-effects (e.g., quinine, some antibiotics), according to the Mayo Clinic.

When I had the blinding case of optic neuritis in 2000, the results of my MRI showed inflammation of the optic nerve but no lesions.

I was not diagnosed with “post-infectious optic neuritis.” I had had a severe cold during the prior weeks. The MRI helped to eliminate the other potential diagnosis suggested, which was brain tumor. Fortunately, I did not have a brain tumor.

Read this post in its entirety:
MS Signs & Symptoms: Optic Neuritis

What is Hypogeusia?

The senses of smell and taste are closely related. Working together they can both alert us to dangers and enhance our enjoyment or dislike of certain foods. Our tongues are covered in thousands of little bumps called taste buds. These taste buds contain receptors that allow us to perceive five elements of taste: sweet, sour, salty, bitter, and savory.

A reduced ability to taste is called hypogeusia. A distortion in taste is called dysgeusia or parageusia. The complete lack of the sense of taste is called ageusia.

There are many things that can alter one’s ability to taste, such as common viral infections, smoking, or certain medications. People with multiple sclerosis (MS) undergoing intravenous steroid treatment for relapse frequently report a temporary “metallic” taste in the mouth. But that’s not the only way that MS might affect taste.

A problem with taste in MS is thought to be rare; but when it does happen, it can seriously impact one’s quality of life. A 2016 study published in the Journal of Neurology reported that taste deficits may be more common in people with MS than previously thought and are associated with MS-related lesions in specific parts of the brain.

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MS Signs & Symptoms: Loss of Taste or Hypogeusia

What is Hyperosmia?

Walking into the kitchen, I stop to ask, “Who got bananas?” My husband replies, “We don’t have any bananas.” But I distinctly smell bananas and now I want one. “I did have some strawberry and banana yogurt earlier today," he says. "I washed out the container and it’s next to the sink." Aha. That’s what I smell.

Sometimes hyperosmia (an increased sense of smell) drives me batty. The smell might be something quite pleasant, like a banana, or something offensive, like my cat going to the bathroom at the other end of the house. Hyperosmia is one of those weird things I’ve learned to live with. It doesn’t affect me all of the time, but occasionally I seem to have the nose of a bloodhound.

An altered sense of smell can be related to multiple sclerosis (MS), neurologic disorders, or other causes. It’s not something that my neurologist routinely questions me about, but it is something you should mention to your doctor if you experience it.

The incidence of impaired sense of smell in people with MS is variable, with estimates ranging from 15 percent to 38.5 percent in different trials. A recent systematic review of the literature found prevalence reports ranging from 20 percent to 45 percent of the MS population. Discrepancies among research results may be due to different testing methods, small numbers of people in the trials, and differences in trial designs.

Read this post in its entirety:
My MS and My Bloodhound Nose

Brrrrr - Cold Temperatures and MS

The start of a New Year is often a bright moment — a chance to look ahead and make grand resolutions and promises to ourselves for the months to come. For me, the new year brings excitement that days will continue to lengthen as the sun sets one minute later each evening. However, the temperatures will also continue to drop and it’s about to feel like winter very soon.

While some people with multiple sclerosis (MS) are heat intolerant and have trouble during the summer, others are sensitive to cold temperatures. Some people, like myself, may be bothered by both extremes as it can become difficult to regulate body temperature due to impaired neural control of autonomic and endocrine functions. The part of the brain that senses core body temperature and regulates it to about 98.6°F can be affected by MS, allowing for atypical fluctuations in body temperature.

Read this post in its entirety:
A Wintery Mix: The Effect of Cold Temperatures on MS Symptoms