To make the most of your neurologist visits, come prepared with a list of any changes in symptoms you’ve experienced — even subtle ones. Here are eight symptoms to keep an eye on.
1. Mobility or Gait Issues
This could mean trouble climbing stairs or walking short distances or tripping more often than you did before. “Your doctor may recommend a gait assessment, refer you to physical therapy, or suggest assistive devices to prevent falls,” says Dr. Gill. They may also prescribe a medication called dalfampridine (Ampyra) that can help improve your mobility and walking speed.
2. Changes in Cognitive Function
Cognitive changes can affect people with SPMS over time. Be sure to tell your doctor if you’re having more difficulty finding words, focusing, or planning. Your neurologist may check for other contributing causes, such as drug interactions from the treatments you’re on. They may also refer you to a neuropsychologist for cognitive testing or rehabilitation.
3. Increased Fatigue
Fatigue is common with SPMS, but if it’s getting worse or affecting your mood, let your doctor know. Your neurologist may recommend energy conservation methods, such as doing tasks during times when you have the most energy. They can also prescribe sleep medications to help you get more rest or order a sleep study to check for sleep disorders. Your neurologist will also check for other factors that may be contributing to fatigue, such as depression, medication side effects, and thyroid issues. “If these factors are adequately addressed, and fatigue is still significantly impacting your functioning, your doctor may consider medications for fatigue,” says Gill.
4. More Muscle Stiffness or Spasticity
Watch out for any cramping, pain, tightening, or difficulty with certain movements. Your doctor may suggest stretching regimens, refer you to physical therapy, or prescribe muscle relaxants or other treatments to help ease symptoms.
5. Changes in Bladder or Bowel Function
These can include issues such as constipation, frequency, hesitancy, and urgency. Your doctor may refer you to a urologist for evaluation or a physical therapist for pelvic floor exercises. They may also have you try medication to relax the bladder muscles, Gill notes.
6. Worsening Mood
Be sure to tell your doctor if you experience changes in your sleep, feel persistently sad, or struggle with motivation. They may refer you to your primary care physician or a psychiatrist to help manage your mental health. But it’s still good for your neurologist to know about mood changes, as they can have an impact on the rest of your SPMS treatment plan.
7. Vision Changes
If you have worsening vision, including double vision or other vision changes, mention it to your neurologist. They will probably refer you to an ophthalmologist or neuro-ophthalmologist. But again, it’s good for them to be aware of any symptoms you’re experiencing, Gill says.
8. A Diminished Libido
Neurological changes due to SPMS can affect sexual function, including decreased sensation and libido and trouble orgasming. Women may have less vaginal lubrication, and men may have erectile dysfunction. Your neurologist may be able to prescribe medication to address these symptoms or refer you to a specialist, such as a sex therapist.
