For me it varies. First time I actually talked with a Dr. and was understood that I ACTUALLY had something REAL going on that COULDN'T be seen by others was when I had the double vision withOUT having ANY alcohol at age 17!
Next time it was regarding my LEFT leg being numb and unable to move my toes or walk very well. Another time was the TN. Nother time my RIGHT foot and entire leg being numb making it almost impossible to walk anywhere even with crutches.
My last big relapse was in the fall of 2012, where my back, tounge, right hand and half of that arm, backside were ALL suddenly totally numb!
My right foot is STILL numb, it's difficult getting around most of the time, but other than that permenat MS thing, I'm back to "normal" now.

Usually for me it comes with numbness of my hands/arms and sometimes legs. Fatigue sets in as well to make it more difficult to deal with.