The first symptoms of multiple sclerosis settle in a few hours or a few days, the time of the “push”. The disease affects young women more.
Inflammatory disease of the central nervous system, multiple sclerosis occurs mainly in women (ratio of 4 women for 1 man), around 30 years old. 4,000 new cases are diagnosed each year in France. On the occasion of the world multiple sclerosis dayon May 30, 2023, we took stock with Professor Jean Pelletier, President of the medical-scientific committee of the foundation ARSEPon the very diverse symptoms of this disease. three in particular have to be spotted at the start.
What are the early symptoms of multiple sclerosis?
“Multiple sclerosis can affect the entire central nervous system that is to say the brain and spinal cord. Various areas are then the target ofinflammatory attacks called “flare-ups” “ immediately reminds our interlocutor. It is during these outbreaks that the symptoms appear. “They don’t set in suddenly (like stroke) but in a few hours or a few days (duration of the thrust, editor’s note)” says Professor Pelletier.
- visual disturbances : there low vision in one eye, a sensation of visual blurring may occur
- sensitivity disorders : feelings of tinglingnumbness of one arm, one leg or both arms or both legs
- motor deficit : an embarrassment to use his hand, to walk at the level of the leg, the limbs are stiffthere is a feeling of instability.
“In general, it evolves very quickly, the symptoms are completely present in a few days” answers the doctor. But this does not mean that the disease is immediately diagnosed. “Sometimes some flare-ups will go away on their own, without treatment. THE symptoms appear and then disappear and it is a posteriori that we will consider that there were previous flare-ups at the time of diagnosis” explains Professor Pelletier.
“There can be several months or even years of delay in diagnosis”.
During the’MRI to confirm the diagnosis of MS, the doctor will observe older lesions in the patient’s brain and spinal cord “which means that thewe are a little late compared to the onset of the disease and first symptoms, this happens in the vast majority of cases.” Without being able to date the appearance of the lesions from the MRI, the doctor believes that there may be “several months or even years late” of diagnosis.
Do symptoms get worse with flare-ups?
The “push” is defined as theappearance of new symptomsthere reappearance of old symptoms or theaggravation pre-existing symptoms. It can last several weeks. Must be distinguished two possible scenarios in the development of multiple sclerosis:
► In the majority of cases, MS is of a “remitting-relapsing” form: “There disease progresses in flare-ups, i.e. there are new lesions and new symptoms. Basic treatments (immunomodulators or immunosuppressants) are then put in place as soon as the diagnosis is made to block the inflammation. This prevents the appearance of new inflammatory lesions, flare-ups and sequelae of these outbreaks.” THE high-dose corticosteroid treatment allows recovery from flare-ups.
“Pains are not the priority symptoms of this disease”
► In a rarer percentage, MS is of the “primary progressive” form : “There disease progresses gradually, that is, there are no flare-ups but progressively worsening symptoms, especially gait disturbances. Management is more complicated because treatments that block inflammation have not shown the same effectiveness to slow the progression of the disease. We then use treatments to improve the symptoms.
Does the disease cause muscle pain?
“Pains are not the priority symptoms of this disease, replies Professor Pelletier. The pain can be linked to contractures, themselves linked to a poor motor function. Spasticity, that is to say stiffness in the legs, can be a source of pain, just as damage to the spinal cord can lead to neurogenic pain. THE facial neuralgia can also be encountered”.
What are the symptoms at a more advanced stage of the disease?
The progression of multiple sclerosis is essentially characterized by balance and gait disorders. “During the course of the disease, or sometimes from the start, symptoms may also appear. visual disturbances with a double sight feeling, problems with the control of the urinary sphincters with feeling of urgency to pee“ answers the specialist. Urinary disorders are “invisible symptoms of multiple sclerosis that bother patients a lot” raises our interlocutor. There are others like cognitive difficulties, “young subjects are bothered by difficulty concentrating, paying attention, and functioning quicklythey find it difficult to do several things at the same time” argues the specialist. Not to mention fatigue “a symptom not visible but extremely frequent. Patients say they are tired without having done anything, everything weighs on them”.
Thanks to Pr Jean Pelletier, President of the medical-scientific committee of the ARSEP foundation