Multiple Sclerosis Symptoms

Last Updated: October 6, 2021

Multiple sclerosis is an autoimmune neurological disease characterized by the destruction of the myelin sheaths (nerve insulators) on neurons in the central nervous system. Its symptoms can vary, but eye pain, difficulty balancing, and numbness, tingling, and weakness in limbs are common. Attacks are “multiple” over time and/or location in the nervous system.


Symptoms can vary depending on the location of demyelination. Below is a list of typical sites for lesions to form and their associated symptoms:[1]

Optic nerve

  • Optic neuritis
  • Pain when moving the eye
  • Blurred vision


  • Instability/dizziness

Spinal cord

  • Weakness in limbs
  • Numbness or tingling in limbs
  • Short electric shock–like sensations
  • Muscle spasticity

Brain stem

  • Blurred or double vision


  • Constipation
  • Increased need to urinate or urge incontinence
  • Erectile dysfunction

Additionally, the diffuse damage in normal appearing white matter (NAWM) and normal appearing gray matter (NAGM) can lead to cognitive dysfunction, which may include issues with:

  • Short-term memory
  • Attention
  • Processing speed
  • Visuospatial skills
  • Executive function

Notably, intellectual function and language typically aren’t affected.[2]

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  1. ^Benjamin K-T Tsang, Richard MacdonellMultiple sclerosis- diagnosis, management and prognosisAust Fam Physician.(2011 Dec)
  2. ^Julie A Bobholz, Stephen M RaoCognitive dysfunction in multiple sclerosis: a review of recent developmentsCurr Opin Neurol.(2003 Jun)
Examine Database References
  1. Cannabis - Mari Carmen Torres-Moreno, Esther Papaseit, Marta Torrens, Magí FarréAssessment of Efficacy and Tolerability of Medicinal Cannabinoids in Patients With Multiple Sclerosis: A Systematic Review and Meta-analysisJAMA Netw Open.(2018 Oct 5)
  2. Cannabis - Jolana Markovà, Ute Essner, Bülent Akmaz, Marcella Marinelli, Christiane Trompke, Arnd Lentschat, Carlos VilaSativex ® as add-on therapy vs. further optimized first-line ANTispastics (SAVANT) in resistant multiple sclerosis spasticity: a double-blind, placebo-controlled randomised clinical trialInt J Neurosci.(2019 Feb)
  3. Vitamin D - Ghasem Mosayebi, Ali Ghazavi, Keyvan Ghasami, Yahya Jand, Parviz KokhaeiTherapeutic effect of vitamin D3 in multiple sclerosis patientsImmunol Invest.(2011)
  4. Cannabis - Letizia Leocani, Arturo Nuara, Elise Houdayer, Irene Schiavetti, Ubaldo Del Carro, Stefano Amadio, Laura Straffi, Paolo Rossi, Vittorio Martinelli, Carlos Vila, Maria Pia Sormani, Giancarlo ComiSativex(®) and clinical-neurophysiological measures of spasticity in progressive multiple sclerosisJ Neurol.(2015 Nov)
  5. Cannabis - Zajicek JP, Sanders HP, Wright DE, Vickery PJ, Ingram WM, Reilly SM, Nunn AJ, Teare LJ, Fox PJ, Thompson AJCannabinoids in multiple sclerosis (CAMS) study: safety and efficacy data for 12 months follow upJ Neurol Neurosurg Psychiatry.(2005 Dec)
  6. Cannabis - Zajicek JP, Hobart JC, Slade A, Barnes D, Mattison PG, MUSEC Research GroupMultiple sclerosis and extract of cannabis: results of the MUSEC trialJ Neurol Neurosurg Psychiatry.(2012 Nov)
  7. Cannabis - C Collin, E Ehler, G Waberzinek, Z Alsindi, P Davies, K Powell, W Notcutt, C O'Leary, S Ratcliffe, I Nováková, O Zapletalova, J Piková, Z AmblerA double-blind, randomized, placebo-controlled, parallel-group study of Sativex, in subjects with symptoms of spasticity due to multiple sclerosisNeurol Res.(2010 Jun)
  8. Biotin (Vitamin B7) - Bruce A C Cree, Gary Cutter, Jerry S Wolinsky, Mark S Freedman, Giancarlo Comi, Gavin Giovannoni, Hans-Peter Hartung, Douglas Arnold, Jens Kuhle, Valerie Block, Frederick E Munschauer, Frédéric Sedel, Fred D Lublin, SPI2 investigative teamsSafety and efficacy of MD1003 (high-dose biotin) in patients with progressive multiple sclerosis (SPI2): a randomised, double-blind, placebo-controlled, phase 3 trialLancet Neurol.(2020 Dec)
  9. Biotin (Vitamin B7) - Tourbah A, Lebrun-Frenay C, Edan G, Clanet M, Papeix C, Vukusic S, De Sèze J, Debouverie M, Gout O, Clavelou P, Defer G, Laplaud DA, Moreau T, Labauge P, Brochet B, Sedel F, Pelletier J, MD1003 (high-dose biotin) for the treatment of progressive multiple sclerosis: A randomised, double-blind, placebo-controlled study.Mult Scler.(2016-11)
  10. Vitamin D - Margitta T Kampman, Linn H Steffensen, Svein I Mellgren, Lone JørgensenEffect of vitamin D3 supplementation on relapses, disease progression, and measures of function in persons with multiple sclerosis: exploratory outcomes from a double-blind randomised controlled trialMult Scler.(2012 Aug)
  11. Vitamin D - Pierrot-Deseilligny C, Rivaud-Péchoux S, Clerson P, de Paz R, Souberbielle JCRelationship between 25-OH-D serum level and relapse rate in multiple sclerosis patients before and after vitamin D supplementationTher Adv Neurol Disord.(2012 Jul)
  12. Vitamin D - J Killestein, E L J Hoogervorst, M Reif, N F Kalkers, A C Van Loenen, P G M Staats, R W Gorter, B M J Uitdehaag, C H PolmanSafety, tolerability, and efficacy of orally administered cannabinoids in MSNeurology.(2002 May 14)
  13. Cannabis - Derick T Wade, Petra Makela, Philip Robson, Heather House, Cynthia BatemanDo cannabis-based medicinal extracts have general or specific effects on symptoms in multiple sclerosis? A double-blind, randomized, placebo-controlled study on 160 patientsMult Scler.(2004 Aug)
  14. Cannabis - D T Wade, P M Makela, H House, C Bateman, P RobsonLong-term use of a cannabis-based medicine in the treatment of spasticity and other symptoms in multiple sclerosisMult Scler.(2006 Oct)
  15. Vitamin D - P Fox, P G Bain, S Glickman, C Carroll, J ZajicekThe effect of cannabis on tremor in patients with multiple sclerosisNeurology.(2004 Apr 13)
  16. Biotin (Vitamin B7) - Sedel F, Papeix C, Bellanger A, Touitou V, Lebrun-Frenay C, Galanaud D, Gout O, Lyon-Caen O, Tourbah AHigh doses of biotin in chronic progressive multiple sclerosis: a pilot study.Mult Scler Relat Disord.(2015-Mar)
  17. Cannabis - Aragona M, Onesti E, Tomassini V, Conte A, Gupta S, Gilio F, Pantano P, Pozzilli C, Inghilleri MPsychopathological and cognitive effects of therapeutic cannabinoids in multiple sclerosis: a double-blind, placebo controlled, crossover studyClin Neuropharmacol.(2009 Jan-Feb)
  18. Ginkgo Biloba - Lovera JF, Kim E, Heriza E, Fitzpatrick M, Hunziker J, Turner AP, Adams J, Stover T, Sangeorzan A, Sloan A, Howieson D, Wild K, Haselkorn J, Bourdette DGinkgo biloba does not improve cognitive function in MS: a randomized placebo-controlled trialNeurology.(2012 Sep 18)
  19. Biotin (Vitamin B7) - Tourbah A, Gout O, Vighetto A, Deburghgraeve V, Pelletier J, Papeix C, Lebrun-Frenay C, Labauge P, Brassat D, Toosy A, Laplaud DA, Outteryck O, Moreau T, Debouverie M, Clavelou P, Heinzlef O, De Sèze J, Defer G, Sedel F, Arndt CMD1003 (High-Dose Pharmaceutical-Grade Biotin) for the Treatment of Chronic Visual Loss Related to Optic Neuritis in Multiple Sclerosis: A Randomized, Double-Blind, Placebo-Controlled Study.CNS Drugs.(2018-07)
  20. Cannabis - W Notcutt, R Langford, P Davies, S Ratcliffe, R PottsA placebo-controlled, parallel-group, randomized withdrawal study of subjects with symptoms of spasticity due to multiple sclerosis who are receiving long-term Sativex® (nabiximols)Mult Scler.(2012 Feb)
  21. Cannabis - Michael G Serpell, William Notcutt, Christine CollinSativex long-term use: an open-label trial in patients with spasticity due to multiple sclerosisJ Neurol.(2013 Jan)
  22. Vitamin D - Raymond Hupperts, Joost Smolders, Reinhold Vieth, Trygve Holmøy, Kurt Marhardt, Myriam Schluep, Joep Killestein, Frederik Barkhof, Manolo Beelke, Luigi M E Grimaldi, SOLAR Study GroupRandomized trial of daily high-dose vitamin D 3 in patients with RRMS receiving subcutaneous interferon β-1aNeurology.(2019 Nov 12)
  23. Cannabis - Zajicek J, Fox P, Sanders H, Wright D, Vickery J, Nunn A, Thompson A, UK MS Research GroupCannabinoids for treatment of spasticity and other symptoms related to multiple sclerosis (CAMS study): multicentre randomised placebo-controlled trialLancet.(2003 Nov 8)
  24. L-Carnitine - Tomassini V, Pozzilli C, Onesti E, Pasqualetti P, Marinelli F, Pisani A, Fieschi CComparison of the effects of acetyl L-carnitine and amantadine for the treatment of fatigue in multiple sclerosis: results of a pilot, randomised, double-blind, crossover trialJ Neurol Sci.(2004 Mar 15)
  25. Vitamin D - William Camu, Philippe Lehert, Charles Pierrot-Deseilligny, Patrick Hautecoeur, Anne Besserve, Anne-Sophie Jean Deleglise, Marianne Payet, Eric Thouvenot, Jean Claude SouberbielleCholecalciferol in relapsing-remitting MS: A randomized clinical trial (CHOLINE)Neurol Neuroimmunol Neuroinflamm.(2019 Aug 6)
  26. Cannabis - R M Langford, J Mares, A Novotna, M Vachova, I Novakova, W Notcutt, S RatcliffeA double-blind, randomized, placebo-controlled, parallel-group study of THC/CBD oromucosal spray in combination with the existing treatment regimen, in the relief of central neuropathic pain in patients with multiple sclerosisJ Neurol.(2013 Apr)
  27. Coenzyme Q10 - Sanoobar M, Eghtesadi S, Azimi A, Khalili M, Khodadadi B, Jazayeri S, Gohari MR, Aryaeian NCoenzyme Q10 supplementation ameliorates inflammatory markers in patients with multiple sclerosis: a double blind, placebo, controlled randomized clinical trialNutr Neurosci.(2015 May)
  28. Cannabis - A Novotna, J Mares, S Ratcliffe, I Novakova, M Vachova, O Zapletalova, C Gasperini, C Pozzilli, L Cefaro, G Comi, P Rossi, Z Ambler, Z Stelmasiak, A Erdmann, X Montalban, A Klimek, P Davies, Sativex Spasticity Study GroupA randomized, double-blind, placebo-controlled, parallel-group, enriched-design study of nabiximols* (Sativex(®) ), as add-on therapy, in subjects with refractory spasticity caused by multiple sclerosisEur J Neurol.(2011 Sep)
  29. Vitamin D - Jody Corey-Bloom, Tanya Wolfson, Anthony Gamst, Shelia Jin, Thomas D Marcotte, Heather Bentley, Ben GouauxSmoked cannabis for spasticity in multiple sclerosis: a randomized, placebo-controlled trialCMAJ.(2012 Jul 10)
  30. Riboflavin (Vitamin B2) - Naghashpour M, Majdinasab N, Shakerinejad G, Kouchak M, Haghighizadeh MH, Jarvandi F, Hajinajaf SRiboflavin supplementation to patients with multiple sclerosis does not improve disability status nor is riboflavin supplementation correlated to homocysteineInt J Vitam Nutr Res.(2013)
  31. Vitamin D - Vahid Shaygannejad, Mohsen Janghorbani, Fereshteh Ashtari, Hamed DehghanEffects of adjunct low-dose vitamin d on relapsing-remitting multiple sclerosis progression: preliminary findings of a randomized placebo-controlled trialMult Scler Int.(2012)
  32. Cannabis - Sven G Meuth, Thomas Henze, Ute Essner, Christiane Trompke, Carlos Vila SilvánTetrahydrocannabinol and cannabidiol oromucosal spray in resistant multiple sclerosis spasticity: consistency of response across subgroups from the SAVANT randomized clinical trialInt J Neurosci.(2020 Dec)
  33. Vitamin A - Sama Bitarafan, Aliakbar Saboor-Yaraghi, Mohammad-Ali Sahraian, Danesh Soltani, Shahriar Nafissi, Mansoureh Togha, Nahid Beladi Moghadam, Tina Roostaei, Niyaz Mohammadzadeh Honarvar, Mohammad-Hossein HarirchianEffect of Vitamin A Supplementation on fatigue and depression in Multiple Sclerosis patients: A Double-Blind Placebo-Controlled Clinical TrialIran J Allergy Asthma Immunol.(2016 Feb)
  34. Cannabis - David J Rog, Turo J Nurmikko, Tim Friede, Carolyn A YoungRandomized, controlled trial of cannabis-based medicine in central pain in multiple sclerosisNeurology.(2005 Sep 27)
  35. Cannabis - C Vaney, M Heinzel-Gutenbrunner, P Jobin, F Tschopp, B Gattlen, U Hagen, M Schnelle, M ReifEfficacy, safety and tolerability of an orally administered cannabis extract in the treatment of spasticity in patients with multiple sclerosis: a randomized, double-blind, placebo-controlled, crossover studyMult Scler.(2004 Aug)