Initially, numbness is the most common sensory symptom, and usually occurs with an onset in one or more limbs. Commonly people awake with abnormal sensation in a portion of a limb, which gradually spreads inward toward the trunk, increasing in extent and intensity. It may extend to include the body trunk. It usually reaches its maximum extent in 2 to 4 days. Sensory disturbance of the legs may or may not occur with a functional abnormality of the legs or bladder. Sometimes this occurs as a first presenting symptom, in the absence of a diagnosis of MS. Because there is often no motor involvement, patients are told it is related to stress or 'neuritis'. This is reinforced by the spontaneous remission of symptoms. Numbness may be accompanied by tingling, or other sensory disturbances. When this occurs after a diagnosis of MS has been established, and is considered to be an attack, or relapse, steroid treatment may be warranted depending on the extent and comfort level of the individual. Management should also consider safety issues and consultation with an occupational therapist may be helpful in this regard.
Sometimes the sensory disturbance can be painful. Achy, burning sensations, a feeling of tightness or banding – these are known as ‘dysesthesias’. These usually respond to anti-seizure medication such as carbemazepine. Amitriptyline can be useful as can be some of the newer pregabalin medications.
Key Healthcare Professionals:
Medical assessment, occupational therapy
Symptom Management:
In addition to medication, safety concerns should be considered if numbness is extensive.
Other Resources:
An MS Society of Canada website that provides information on a variety of topics. Information is provided by a range of North American experts who respond to inquires from individuals affected by MS.
