Dysautonomia, or autonomic dysfunction, is any disease of the autonomic nervous system. Malfunction in the autonomic nervous system can occur in MS as those fibers may also be demyelinated in the brainstem or spine. Typically, patients experience issues with edema or ruddiness in their lower extremities, especially if they remain dependent. Bladder dysfunction is typically a function of spinal cord changes that disinhibit certain muscles and activate others, leading to urgency and/or retention. Cognitive changes are often due to neuronal loss in various parts of the brain. However, MS patients rarely experience such autonomic changes as changes in their vital signs. It would be atypical for an MS patient to have severe autonomic dysfunction without severe brain stem or cord disease and should lead to a search for an alternative cause.