https://link.springer.com/article/10.1007/s10286-020-00676-3 Autonomic dysfunction, namely gastrointestinal, genitourinary, and cardiovascular abnormalities, is a key feature of the prodromal phase of other neurological disorders, such as Parkinson disease and other synucleinopathies [6]. Analog changes appear to occur in patients with MS, with sexual dysfunction appearing in later stages of disease and among patients with more advanced disability scores Presentation of multiple sclerosis, from the prodromal or presymptomatic stage to secondary progressive multiple sclerosis. CIS clinically isolated syndrome, RRMS relapsing remitting multiple sclerosis, SPMS secondary progressive multiple sclerosis. Time in Years: