The cerebellum is located in the lower-back region of the brain, and helps to control movement, coordination, balance, and muscle tone. While demyelination in this area can cause tremor for some individuals, it can cause balance problems as well. Other components, such as vision, hearing, and movement of the arms and legs, are also involved in balance. Problems with the functioning of any of these areas can worsen balance, but conversely, some of these areas may be able to compensate for other deficits in balance.

Vertigo, or the sensation of “spinning,” may occur as the result of lesions in the brain areas that coordinate balance.

Fatigue has been described as an “overwhelming sense of tiredness.” Up to 80 percent of people with MS experience the disabling effects of fatigue. This overwhelming tiredness could occur any time in the course of MS, and it has not been shown to be related to measures of disability like the EDSS (Extended Disability Status Scale). Many people with MS find that fatigue increases as the day goes on, and worsens with a rise in body temperature, which might be caused by hot and humid weather.

A very common symptom of MS is numbness, often in the limbs or across the body in a band-like fashion.

More than 50 percent of individuals with MS identify pain as a significant symptom. For many years, the medical community did not support the idea that pain could be caused by the effects of MS, but physicians today recognize that pain is a common symptom.

There is nothing like a good night’s sleep to restore oneself physically, mentally, and emotionally. Unfortunately, more than half of people with MS experience difficulty sleeping. Inadequate sleep leads to fatigue, the most common and one of the most debilitating symptoms of MS. It also causes daytime drowsiness, lack of mental clarity, and a reduced ability to use one’s resources to solve problems.

Uhthoff’s syndrome is described by patients as a dimming or reduction in vision, usually associated with exercise or overheating. It indicates partial myelin damage along the optic nerve as the visual signal goes from the eye to the brain. As a person’s temperature rises, even by less than one degree, the ability to conduct nerve impulses along damaged nerves is reduced. This visual problem improves with rest.

Visual problems are common among those with MS and are often a first sign of the disease.

Individuals may experience weakness for different reasons. For people with MS, demyelination interrupts the flow of nerve impulses in the spinal cord or (less frequently) in the brain that keep a muscle or group of muscles functioning properly. As a result, muscles lose strength.