What Symptoms Suggest I Might Have MS?

Talk show host Montel Williams' first symptom of multiple sclerosis was visual blurriness and a blind spot. Ann Romney, wife of former presidential candidate Mitt Romney, felt her hands shake. For actress Terri Garr, it was stumbling during her routine jog through Central Park. And Fox Business anchor Neil Cavuto experienced episodes of tingling in his extremities.

Such is the "trickster" nature of MS, a chronic and often disabling disease of the central nervous system affecting the brain and spinal cord. Symptoms can vary wildly, and for the majority of the 400,000 Americans who suffer with MS, signs of the disease come and go. That can mean if symptoms aren't recognized early it may take years, even decades, for MS to be treated. But the sooner there's treatment, the later a relapse of the disease may occur, according to a 2016 study of 468 MS sufferers reported online in the journal Neurology.

[See: 10 Seemingly Innocent Symptoms You Shouldn't Ignore.]

Even though recognizing the symptoms of MS is crucial, it's often not simple. "Some symptoms are subtle, such as temporary tingling or numbness in a hand or foot, and others are dramatic like vision involvement or extreme fatigue," says Dr. Lauren Krupp, professor of neurology and the director of NYU Langone's Multiple Sclerosis Comprehensive Care Center.

"Since symptoms can be illusive, the onset of MS may be misdiagnosed or ignored for years," Krupp adds. "But once the patient sees a neurologist, a medical history and MRI will be taken, and if it's MS, telltale scars [lesions] on the brain or spinal cord will appear.

"MS affects the immune system attacking the protective [myelin] sheath that covers nerve fibers and disrupts communication between the brain and the rest of the body," explains Dr. Bardia Nourbakhish, assistant professor with the Multiple Sclerosis Center at Johns Hopkins Medicine.

What Symptoms Should I Look For?

The Harvard Medical School website points out that symptoms vary depending on the area of the brain or spinal cord that's affected. The National Multiple Sclerosis Society says the most common ones include:

-- numbness or tingling often felt in the torso, face, arms and legs

-- fatigue so extreme it interferes with everyday activities

-- problems with walking because of balance, muscle weakness, stiffness or fatigue

-- visual issues such as blurring, pain with eye movement and temporary blind spots

-- dizziness and vertigo

-- constipation or loss of control of the bowels

-- bladder issues, which affect 80 percent of people with MS

-- and problems with cognitive function causing an inability to focus, organize, process new information and problem solve.

[See: 17 Ways Heart Health Varies in Women and Men.]

There are also less common symptoms, including: problems swallowing; uncontrollable shaking; speech issues (slurring, loss of volume, occasional stuttering); the sensations of itching, pins and needles, and burning; headache; breathing problems and hearing loss.

According to the University of Maryland Medical Center's website, MS can be confused with dozens of other illnesses, from Lyme disease and lupus to fibromyalgia, rheumatoid arthritis and stroke, among others.

"Whatever symptoms you may be experiencing, a good rule of thumb is to go to the doctor when things don't seem right," Krupp says. "If your diagnosis is MS, the type you have will likely also be identified."

[See: 5 Rare Diseases You've Never Heard of (Until Now).]

Types of MS

The National MS Society categorizes four types of MS:

-- Clinically Isolated Syndrome, or CIS, describes the first episode of neurological symptoms. It must last for at least 24 hours but won't necessarily lead to a diagnosis of MS unless lesions are seen on a brain MRI. An individual in this case has a high likelihood of a second episode of symptoms and a diagnosis of MS.

-- Relapsing-remitting MS, or RRMS. About 85 percent of people with MS (mostly women between 20 and 50, but children as well), are initially diagnosed with this form of MS. It's characterized by periods of active symptoms alternating with periods of remission, during which symptoms are less severe or may even disappear for a time.

-- Primary progressive MS, or PPMS, is a rare form and progresses from the start with no acute relapses and remissions in symptoms. Between 10 to 15 percent of people with MS are diagnosed with this type.

-- Secondary Progressive MS, also known as SPMS. Over time, as many as 85 to 90 percent of people diagnosed with RRM develop secondary-progressive MS, in which symptom flare-ups continue, new symptoms can appear and the disease steadily progresses, leading to increasing levels of disability usually five to 15 years after the initial MS diagnosis.

What's the good news? For most patients, the disease is manageable. As Nourbakhish says: "There are effective treatments including medications, behavioral modification and rehabilitation for the most common symptoms of MS."

Robin Westen is a freelance Health reporter at U.S. News. She's an award-winning journalist who has written for numerous national magazines, including AARP, Family Circle, Psychology Today, MORE, Health, Self, Parents, Glamour and Cosmopolitan, in addition to others. She has authored more than a dozen books on health and relationships, including "The Yoga-Body Cleanse," "The Complete A to Z for Your V," "Ten Days to Detox" and "808 Conversation Starters for Couples," among others. Westen also won an Emmy for her writing on the ABC show "FYI."