People with multiple sclerosis (MS) have a higher risk of stroke compared to those without the condition. Stroke is a serious health problem that can be life-threatening. To add to the challenge, strokes and MS flares can share similar symptoms, which might delay an accurate diagnosis and timely treatment. Recognizing the signs of a stroke and knowing when to seek emergency treatment just might save your life.

Keep reading to learn about the causes of stroke, why people with MS are at higher risk, and steps you can take to protect yourself or someone you care about.

What Is a Stroke?

There are two main types of stroke:

• Ischemic stroke — An ischemic stroke is the most common type, which occurs when some of the brain’s blood supply is blocked, causing brain tissue damage within minutes. Ischemic strokes are often caused by cardiovascular disease.
• Hemorrhagic stroke — This type of stroke is less common and is caused by a blood vessel in the brain bursting.

Emergency Treatment

If you have MS and suddenly develop new or severe symptoms, go to the ER — even if you think it might just be a relapse. Symptoms that may indicate stroke and not an MS relapse include:

• Sudden numbness or weakness, especially on one side of the body
• Sudden vision loss, especially in one eye
• Slurred speech, confusion, or nonsensical words
• A rapid and dramatic increase in walking difficulty
• Sudden severe headache

How Can You Tell the Difference Between Symptoms of MS and Stroke?

The symptoms of an MS relapse are unpredictable, but they often involve:

• Vision problems
• Difficulty walking
• Weakness
• Numbness or tingling
• Paralysis
• Pain
• Balance problems
• Loss of bowel or bladder function

Most people with relapsing-remitting MS go through cycles of symptom flare-ups followed by periods of recovery.

Stroke symptoms depend on where the brain is damaged, but these symptoms can be almost identical to those of an MS relapse.

Sudden vs. Gradual Onset

A noticeable difference between MS flares and a stroke is the sudden onset of stroke symptoms. While symptoms of an MS relapse can sometimes come on suddenly, they usually emerge over a couple of days. It could be one or several symptoms, ranging from mild to severe. A relapse could also be the worsening of an MS symptom you already live with.

Stroke symptoms often appear suddenly, but they can also develop gradually over days or weeks. This can make it hard to know if a new or worsening MS symptom is a relapse or a stroke.

If you suspect a stroke, contact emergency services immediately. To treat a stroke successfully, doctors need to act within four hours of when symptoms start. If you’re in doubt about whether you’re experiencing a stroke or MS relapse symptoms, seek emergency medical care.

One member of MyMSTeam described repeated evaluations for stroke: “Over the years, I had headaches, numbness, tingling, fatigue, foot drop. I fell and broke my kneecap. Each time, the local doc said, ‘No stroke. Good news.’” Another member mentioned, “I have MS and have had a right side stroke, but my problems resolved quickly!”

Sometimes, people experience strokelike symptoms for a short time (typically less than an hour), and then the symptoms disappear. This is known as a transient ischemic attack (TIA). It can be a warning sign of a future stroke or more TIAs, so it’s important to follow up with your doctor.

MS and Stroke Risk Factors

People with MS are usually diagnosed between 20 and 40 years old. According to the National Multiple Sclerosis Society, women are three times more likely to develop MS than men. While more common in white populations, people of all racial and ethnic backgrounds can develop MS.

On the other hand, older people are at greater risk of stroke, with 75 percent of strokes occurring in those over 65 years of age. According to the National Institutes of Health, men are more likely to have strokes than women, and there’s a higher risk among African American, Hispanic American, and Native American populations.

Regardless of your risk factors, never delay seeking immediate care if you suspect a stroke.

Can MS Cause a Stroke?

Over the years, several studies have linked MS with a higher stroke risk. A 2024 meta-analysis study found that individuals with MS were at a higher risk of ischemic and hemorrhagic strokes.

The study also discovered that the prevalence, or how common stroke is, decreased as people with MS aged.

Another 2024 study noted that people with MS had a 2.02 times greater risk of an ischemic stroke and a 2.65 times greater risk of an intracerebral hemorrhage compared to people without MS. Years after an initial diagnosis of MS, individuals still had a 1.29 percent higher chance of having a stroke.

Despite current findings between MS and stroke, more research is needed to further understand the relationship and find better prevention and treatment options.

There’s currently no evidence to suggest that having a stroke increases your risk of ultimately having MS. Nevertheless, certain risk factors for MS and stroke overlap.

Shared Risk Factors for MS and Stroke

Several risk factors are common to both MS and stroke, including:

• Smoking
• Low vitamin D levels
• Shared vascular risks and potential genetic similarities
• Chronic inflammation, which may cause damage to the lining of blood vessels and the hardening of artery walls
• Autoimmune diseases, such as rheumatoid arthritis and psoriasis, which occur when the immune system mistakenly attacks the body’s own tissues. If you have an autoimmune comorbidity (an autoimmune disease alongside MS), you may have a higher risk for stroke and heart disease.

Lowering Your Risk of Stroke

If you have MS, you have an increased risk of dying if you have a stroke. For this reason, lowering your stroke risk is critical.

If you’re concerned about your risk for stroke and other cardiovascular diseases, talk to your neurology team or another health care professional about how to manage that risk and improve your quality of life. Your doctor may recommend medication, moderate physical activity, and healthy diet changes can help protect you against vascular disease. If you have high cholesterol, a cholesterol-lowering medication, specifically statins, can be an effective treatment.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 217,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with MS and worried about your risk for stroke? Share your experience in the comments below, or start a conversation by posting on your Activities page.