Charcot’s neurological triad refers to the three symptoms Charcot identified as fundamental to MS: nystagmus, intention tremors, and scanning or staccato speech — and I live with all of them. I looked at the three traits carefully and soon realized that each one of those traits deals with the cerebellum — the part of the brain responsible for coordinating voluntary movement in addition to balance and posture. As I look at my 35-year journey with MS, I have come to realize that I have incurred a lot of cerebellar damage. As a matter of fact, the first symptom I had was related to a small speech abnormality. I was only 19 years old when that happened, and for whatever reason, my cerebellum had been the focus of an MS attack and demyelination. Of course, not all my major MS symptoms are the result of cerebellar damage, but my MRI tests from years ago revealed extensive cerebellum demyelination.
Nystagmus Causes Jerky Eye Movements
Nystagmus is the ever-annoying jerky eye movement that disrupts my vision. The whole situation is nothing but cruel. The eye movements are not coordinated and have forced me to stop driving. If I focus on something, like watching a movie or looking at my computer screen, I have to sit and wait for my eyes to “settle down.” If I focus on anything, for that matter, the uncoordinated eye movements kick in. It’s become a way of life. I have found that sometimes closing the eyes for a minute or two will help to calm things down, slightly. This short time of relaxation is also a time when I reflect on the fact that what is happening is not my fault. RELATED: Eye Complications Associated With Multiple Sclerosis
Intention Tremor Occurs at the End of Purposeful Movement
Nystagmus is annoying, but nothing is more unpredictable and annoying than intention tremor. And to think that Charcot had an understanding of this phenomenon 150 years ago! Intention tremor in my life is a curse! The tremors have only increased as I have progressed. At one time I tolerated Inderal (propranolol), a beta-blocker which helped to quell the tremors. Now the asthma caused by Samter’s triad (see below) prevents me from taking any beta-blocker. Then I started taking Zoloft, because it helped my pseudobulbar issues. One of the side effects of SSRI medications (selective serotonin reuptake inhibitors, of which Zoloft [sertraline] is one) is, you guessed it, tremors! Intention tremors in MS occur during movement, unlike Parkinsonian resting tremors, which happen while a person is resting rather than in motion. When I start to type on the computer keyboard, the shakes caused by intention tremor cause me to make myriad mistakes, from spelling errors, to getting lost in my document, to losing my document; I have to hunt-and-peck my way to finishing anything. The existing tremors were only made worse by the Zoloft, and everything is compounded by nystagmus. So everything that is happening is because of damage to the “little brain,” the meaning of cerebellum in Latin. The structure itself is located in the hindbrain near the brain stem area and looks like a miniature brain. This powerful little organ is in control of all my motor skills. Hand tremors are annoying, but neck and head tremors, which I have, are debilitating. I have to drink liquids through a straw. If I attempt a glass, my head shakes uncontrollably. RELATED: Getting a Handle on MS Tremors and Shakes
Dysarthria Causes Speech That Is Hard to Understand
The third piece of Charcot’s triad includes speech disorder, mainly “scanning” or staccato speech. In this situation, there is a disruption in speech flow. I know I don’t have that, exactly, but I’ve always known, from the time of my episode with the speech center incident in the early 1980s, that something is not quite right. Friends say nothing is wrong, but inside I feel I’m constantly compensating for something I can’t put my finger on. RELATED: 9 Surprising Symptoms of Multiple Sclerosis
I Also Live With Samter’s Triad
Last year I found out I had another strange autoimmune condition in addition to multiple sclerosis. That condition is known as Samter’s triad, and consists of asthma, nasal polyps, and sinus issues. I guess bad things come in threes. I suffered with symptoms of Samter’s triad for years — 10 to be exact — without understanding what was wrong, because I thought I had allergies. Well, that seemed manageable, until I couldn’t breathe because of nasal polyps. No one knew what to do, and my primary care doctor hadn’t even heard of the condition until I told her about it. So I advocated for myself and underwent sinus surgery in December 2020. Today, I am happy to be able to breathe again. But like MS, Samter’s triad is an incurable, life-long condition. I can breathe again, but it requires constant management, particularly with persistent asthma.
It Helps to Realize None of This Is My Fault
Having these symptoms makes me feel like a freak, with tremors, uncoordinated eye movements, and the constant worry that speech might be next. What do I have left? I think I have a brain that is constantly rerouting around damaged areas to allow my mind to function. I do need a way to mitigate the tremors that make me constantly knock things over, then have to go through the ordeal of picking them up, only to knock them over again. Right now, it feels like these tremors are just beyond my control. I have decided to wear one-pound wrist weights on both arms to dampen the tremors. Not sure it will work, but it’s worth a try. With all of this happening — living with two chronic conditions at once and the many symptoms they cause — I do take solace in the fact that none of this is my fault.
