include weakness, numbness, tremor, loss of vision, pain, paralysis, loss of balance, and bladder and bowel dysfunction.
Secondary symptoms are discussed by Schwarz (1999) as complications that arise as a result of the primary symptoms. For example, bladder dysfunction can cause repeated urinary tract infections. Inactivity can result in weakness from lack of muscle use (not related to demyelination), poor postural alignment and trunk control, muscle imbalances (adaptive shortening and/or stretch weakness), decreased bone density (osteoporosis increasing risk of fracture), and shallow, inefficient breathing. Paralysis can lead to the secondary symptom of bedsores.
Tertiary symptoms, according to Schwarz (1999) are the social, vocational and psychological complications of the primary and secondary symptoms. For example, a person who becomes unable to walk or drive may lose his or her livelihood. The strain of dealing with a chronic illnesses caused by MS may disrupt personal relationships. Schwarz notes that depression is frequently seen among people with multiple sclerosis; often, it is not really a direct symptom of the disease but rather a reaction to the various social, vocational and psychoemotional consequences of the condition.
Other symptoms of multiple sclerosis may include: dizziness and vertigo; difficulty in swallowing; headache; hearing problems; itching; pain; seizures; loss of sexuality or sexual problems; and stiffness.
According to Giovannoni and Miller (1999), the precise causes of multiple sclerosis are not yet known; however, scientific research indicates that the condition is multiply determined. Most probably, MS involves the following factors: Immunologic/auto-immune factors; environmental factors; viral factors, genetic factors, and trauma.
Regarding immunologic factors, Giovannoni and Miller (1999) state that the condition is generally believed to be associated with an abnormal response...