Historically, the number of senses have differed along with the definition of
what constitutes a sense. The traditional five senses are sight, hearing, touch,
smell, taste. These five senses can be attributed to Aristotle and his theory of
sense perception. People are also considered to have at least five additional
senses that include: Nociception (pain), equilibrioception (balance),
proprioception & kinesthesia (joint motion and acceleration), sense of time,
thermoception (temperature differences), with possibly an additional weak
magnetoception (direction).
When you have multiple sclerosis (MS) early on, it can cause some anxiety for
the simple fact that you have no idea what to expect and how to deal with it.
The symptoms vary widely from person to person and also in the severity. One
person may experience mild pain on the left side of their body while another may
have severe pain only in their right arm. Everything depends upon the location
of the damaged myelin, the severity, and the number of areas with damage.
Sensory symptoms are the most common symptom of MS, with up to 90% of those with
MS reporting some form of numbness and tingling. The main sensory symptoms
include numbness, tightness, tingling or burning. At times these sensations are
painful but even when they aren't painful, they may change how you move and can
affect balance and decrease mobility.
The location specifically determines the type of symptoms you may experience.
The greater the damage at any given location will typically determine the
severity. The number of areas with damage will typically have a great impact on
the effect on all your symptoms. With this in mind, one area with severe damage
may have the same impact as 10 locations with mild damage. It's therefore
difficult to determine what any single person should expect, but rather what
most people in general do expect or experience on a daily basis.
The nervous system includes many sensory nerve fibers dedicated to helping you
be aware of your environment. They provide the sense of touch in your fingers,
and your ability to feel cold or heat on all parts of your body. When these
fibers are damaged by MS, your sense of touch may be replaced by feelings of
numbness or tingling. Parts of your body may feel burning or cold, even though
there is no heat or chill present. MS symptoms can be temporary or more
progressive, and can occur in various parts of the body.
There are many nerves involved in transmitting taste and smell information to
the brain. Taste receptors are found within taste buds, not only on the tongue,
but also on the soft palate, pharynx, larynx, epiglottis, uvula, and the top
third of the esophagus. Complete loss of taste is very rare, even in MS, but
impaired taste or distorted taste may occur with demyelization of any of the
nerves involved. In particular, the Trigeminal Nerve or 5th Cranial Nerve plays
an important part in the taste and smell process.
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Sensory ataxia is the lack of coordination caused by numbness in the feet and
is a fairly common symptom of MS. It's different from ataxia, which is weakness
or lack of coordination caused by lesions in the cerebellum.
The term sensory ataxia is employed to indicate ataxia due to loss of
proprioception (sensitivity to joint and body part position), which generally
depends on dysfunction of the dorsal columns of the spinal cord, since they
carry proprioceptive information up to the brain. In some cases, the cause may
instead be dysfunction of the various brain parts that receive that information,
including the cerebellum, thalamus, and parietal lobes. Sensory ataxia presents
with an unsteady "stomping" gait with heavy heel strikes, as well as postural
instability that is characteristically worsened when the lack of proprioceptive
input can't be compensated by visual input, such as in poorly lit environments.
Doctors can evidence this during physical examination by having the patient
stand with their feet together and eyes shut, which will cause the patient's
instability to markedly worsen, producing wide oscillations and possibly a fall
which is called a positive Romberg's test. Worsening of the finger-pointing test
with the eyes closed is another feature of sensory ataxia. Also, when the
patient is standing with arms and hands extended toward the examiner, if the
eyes are closed, the patient's finger will tend to "fall down" and be restored
to the horizontal extended position by sudden extensor contractions or "ataxic hand".
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The nervous system includes many sensory nerve fibers dedicated to helping you
be aware of your environment. They provide the sense of touch in your fingers,
and your ability to feel cold or heat on all parts of your body. When these
fibers are damaged by MS, your sense of touch may be replaced by feelings of
numbness or tingling. Parts of your body may feel burning or cold, even though
there is no heat or chill present. MS symptoms can be temporary relapses or more
progressive, and can occur in various parts of the body.
Most commonly referred to as "numbness" or "tingling," this is one of the MS
symptoms that most people seek help for.
It typically involves feelings of:
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Numbness |
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Pins and needles |
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Burning |
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Severe itchiness |
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Tingling, buzzing, vibrating sensations |
Sensory symptoms are the most common symptom of MS, with up to 90% of people
with MS reporting some form of numbness and tingling. Paresthesias (as discussed
further below) in MS are caused by lesions on the brain or spinal cord. They can
be as a result of touch causing a sensation to be much more intense than a
normal touch. They can also just occur spontaneously.
Often, this numbness and tingling sensation occurs as part of a
pseudo exacerbation, which is a temporary increase in symptoms caused by an
external factor. Usually this is a result of MS-related heat intolerance or as a
result of MS fatigue. If this is the case, the sensation should go away or
greatly lessen in intensity once you are cool and/or rested. The sensation
usually appears in the hands and/or feet, then moves progressively closer to the
core up the arms and legs, although it can appear anywhere.
Those with MS who have severe facial numbness should be very careful when eating
or chewing, as they may unwittingly bite the inside of their mouth or tongue.
People with numbness over other parts of the body should be careful around
fires, hot water and other sources of heat, as they may suffer a burn without
realizing it.
There are currently no medications to relieve numbness. Most instances of
numbness are not disabling, and tend to remit on their own. In very severe
cases, a neurologist may prescribe a brief course of corticosteroids, which
often can temporarily restore sensation.
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MS hug (also referred to as MS girdle or girdle-banding) is a tightening feeling around
the chest or abdomen and can range from annoying pressure to extreme pain. This is why
people often say it’s like wearing a girdle around the middle of your body.
The sensation itself is the result of the intercostal muscles between each rib going into
spasm. These muscles hold your rib cage together and help it expand when you move, bend,
or breathe. When these muscles spasm, you feel painful, tightening pressure. The burning,
aching, or girdling pain around the body are all neurologic in origin. The technical name
for these types of pain is dysesthesias.
Like most symptoms of MS, the feeling is different for each person. You might have pain
under your rib cage or anywhere between your neck and waistline. It can be dull and achy,
sharp, or burning. It can last a few seconds to a few hours, and in rare cases, a few days.
Some people describe a slight tingling or tickling vibration, while others say it’s a
crippling pressure below their ribs that can make it hurt to breathe. It can begin with
a sudden and intense tightening around your chest, along with pain and a burning sensation.
It will typically cause you to clutch your chest and bring in a sense of fear. The first
time this is experienced, you might wonder if it's a heart attack, a panic attack, an
asthma attack, or something similar. If you feel that it may be an MS Hug, then you will
should contact your neurologist.
Although it's an extremely unpleasant neurological event, it's not life-threatening. As
with most symptoms of MS, the MS Hug feels differently to every individual. It has been
described as feeling like being squeezed by a boa constrictor, compressed with an
ever-tightening rubber band, or wearing a chest high girdle. It's important to know
that the MS Hug actually doesn't interfere with the ability to breathe.
These pains are often treated with the anticonvulsant medication gabapentin. Dysesthesias
may also be treated with an antidepressant such as amitriptyline, which modifies how the
central nervous system (CNS) reacts to pain. Other treatments include wearing a pressure
stocking or glove, which can convert the sensation of pain to one of pressure; warm
compresses to the skin, which may convert the sensation of pain to one of warmth; and
over-the-counter acetaminophen which may be taken daily, under a physician's supervision.
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Pruritis (itching) may occur as a symptom of MS. It's one of the family of
abnormal sensations such as "pins and needles" and burning, stabbing, or tearing
pains which may be experienced by those with MS. These sensations are known as
dysesthesias, and they are neurologic in origin.
This is different from allergic itching in that dysesthetic itching may occur
suddenly and intensely, but for brief periods. It may be present over any part
of the body or face. It's different from the generalized itching that can
accompany an allergic reaction, as there is no external skin rash or irritation
at the site of itching. Corticosteroid ointments applied to the skin are not
helpful in relieving this type of itch.
There are several medications that are usually successful in treating
dysesthetic itching. Among them are: anticonvulsants such as carbamazepine,
diphenylhydantoin, and gabapentin; antidepressants such as amitriptyline and the
MAO inhibitors; and antihistamines.
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