Sensory disorders in multiple sclerosis (numbness, tingling, etc.)

Multiple sclerosis (MS) is a chronic autoimmune disease of the brain and the spinal cord. In MS, the patient's immune system attacks a protein that is essential for the propagation of nerve impulses - myelin - and cells that produce it.

As a result, MS affects movement, senses and balance, among other things. In the UK, there are more than 300,000 multiple sclerosis patients.

What sensory impairments are caused by multiple sclerosis? 

Sensory problems manifest themselves as abnormal sensations, which may be more or less unpleasant and/or more or less painful. They are caused by damage to the sensory pathways that travel via the nerves and the spinal cord to the brain.

The nerves form a large network in the body and are connected to the spinal cord, through which they communicate with the brain. For example, they are used to transmit sensory messages to the brain, such as heat or cold.

MS can lead to alterations in the communication of sensory information, and the transmission of sensory messages may be disrupted as a result. A sensory disorder may also correspond to an abnormal sensory message.

In multiple sclerosis, various sensory disorders can be found:

Paresthesia 

Paraesthesia is a disorder of the sense of touch, combining a number of unpleasant but non-painful symptoms: tingling, pins and needles, numbness, etc.

Paraesthesia can affect different areas of the body: one or two limbs, for example, or even an entire side of the body.

Dysaesthesia

Dysaesthesia occurs when the sensitivity of a part of the body is altered. It corresponds to a reduction or, on the contrary, an exaggeration of sensitivity. Dysaesthesia occurs, for example, when something is in contact with the skin (rubbing a sheet or piece of clothing). Such contact may become unpleasant or even painful.

Dysaesthesia includes tingling, pins and needles, burning and/or irritation, pain and numbness.  

Hyperpathy

Hyperpathy is characterised by an abnormally painful sensation experienced when confronted with a repetitive stimulus, and which persists when the stimulus is gone: contact with something cold, palpation, joint mobilisation, a piece of clothing touching the skin, etc. The pain often affects a wider area than the one initially stimulated.

Lhermitte's sign 

Lhermitte's sign is a painful sensation that causes an electric shock running up and down the body when the head and neck are flexed.

Proprioception problems 

Proprioception - or deep sensitivity - refers to all the mechanisms used for perceiving different parts of the body. In particular, it enables us to walk, even without using our vision. When the nerves involved in deep sensibility are impaired, problems with balance and movement can occur.

How do sensory impairments caused by MS evolve? 

Sensory problems can appear at any time during the course of multiple sclerosis (MS). They may be present from the very first symptoms, or may develop later. Since sensory problems are linked to damage to the sensory nerves, their arrival depends on how the multiple sclerosis progresses. This differs from patient to patient, and it is difficult to predict.

The evolution of these symptoms also depends on the course of the disease itself. They may appear during a relapse and, when the relapse is over, may disappear completely or leave certain sequalae, more or less serious.

In the case of progressive MS, these sensory problems may become chronic and worsen as the disease progresses.

How can sensory problems related to MS be treated? 

If sensory problems are due to a multiple sclerosis relapse

If sensory problems appear during an MS relapse, they can only be managed by treating the relapse itself. Treatment during relapses can limit or even eliminate the symptoms associated with them.

In addition, taking a disease-modifying treatment helps to prevent the onset of multiple sclerosis relapses, and therefore also helps to limit the associated symptoms and sensory disorders.

If sensory disorders are chronic 

The management of MS-related sensory disorders will depend on their intensity and their impact on patients' quality of life.

When sensory problems are not painful, or cause little or no discomfort, treatment is not systematically proposed. However, if sensory disorders cause significant and frequent pain, a number of therapeutic approaches may be considered, including drug treatment (neuroleptics, antidepressants), transcutaneous electrical stimulation (TENS), relaxation, hypnosis and psychotherapy.

If you are experiencing one or more sensory problems, talk to your neurologist as soon as possible. Following an assessment, he or she will be able to suggest the most appropriate treatment.