This text provides general information and is no substitute for medical advice. Diagnosis and treatment belong in the hands of neurologists; never stop prescribed medication on your own. Rules, approvals and guidelines differ from country to country; sources marked (German) refer to Germany.
Early signs
At the start there are often non-specific or short-lived complaints. Typical are:
- blurred or dimmed vision in one eye, often with pain on eye movement (optic neuritis),
- tingling, numbness or “pins and needles” in parts of the body,
- weakness or heaviness in arms or legs,
- unsteady gait, dizziness, double vision.
These signs have many possible causes. If they last longer than a day or come back, have them checked by a neurologist.
Common symptoms over time
- Fatigue: pronounced exhaustion that sleep does not fix; one of the most common symptoms. More in the fatigue planner (in German).
- Spasticity and muscle weakness, stiffness, walking problems.
- Sensory disturbances and pain, for example burning or electric-shock-like sensations.
- Bladder and bowel problems, such as urgency or constipation.
- Cognitive problems: concentration, memory and thinking speed (see keeping your head fit in daily life, in German).
- Mood changes, depression and anxiety.
- Sexual dysfunction.
Hardly anyone has all of these symptoms. Heat can temporarily worsen complaints (Uhthoff phenomenon); they usually recede when body temperature falls. Tips: heat and summer with MS (in German).
What is a relapse?
A relapse is newly appearing or worsening neurological symptoms that last at least 24 hours, occur at least 30 days after the last relapse and are not explained by fever or infection. Relapses often recede on their own but sometimes leave lasting impairment.
If you suspect a relapse, call your neurology practice promptly. Depending on severity, doctors usually treat with a short course of high-dose corticosteroids.
When to see a doctor?
See a neurologist promptly if vision, sensation or movement problems last longer than 24 hours, appear suddenly or return. In case of sudden loss of vision, paralysis or speech problems, call your local emergency number (112 in the EU, 911 in the US), because these can also be other emergencies such as a stroke.
Frequently asked questions
What are the first symptoms of MS?
Often vision problems in one eye, tingling or numbness and weakness in arms or legs. They are not proof of MS, though.
Can MS cause fatigue?
Yes. Fatigue is among the most common MS symptoms and often occurs even without physical effort.
How long does an MS relapse last?
Usually days to a few weeks. Recovery can be complete but can also leave residual symptoms.
Sources
- DGN/AWMF guideline (German): diagnosis and treatment of multiple sclerosis, neuromyelitis optica spectrum disorders and MOG-IgG-associated diseases (030-050)
- Lublin FD et al.: Defining the clinical course of multiple sclerosis. Neurology 2014;83:278-286
- Deutsche Multiple Sklerose Gesellschaft (DMSG), federal association (German)
As of: 2026-11-02. More basics: What is multiple sclerosis (MS)? · MS diagnosis: how multiple sclerosis is established · MS treatments at a glance.