As the disease progresses, the 'inbuilt' nervous tension increases and they become irritable. They rarely lose their inclination to work and produce unless severely disabled. In general, they become very well informed about their disease through reading and discussions with one another. It is, therefore, very difficult if not impossible to keep information concerning their disease from them. These characteristics are so frequently observed in the multiple sclerosis patient that their absence in the early phase of the disease should cause one to reexamine the history for clues to another diagnosis.
Most patients have cold feet and hands, and they are often cold in a warm room.
Some may have spells of being overheated and many experience night sweats. They bruise easily and often suffer from multiple subcutaneous hemorrhages for no known reason. Patients with established multiple sclerosis withstand both psychological and physical stress poorly. In the face of anxiety or nervous tension, whatever the cause, patients note fatigue and a reduced ability to perform. The news of a death in the family, continuing domestic and marital difficulties, loss or threatened loss of the means of financial support, and accidents of a frightening nature are frequently followed by increased disability.