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MULTIPLE SCLEROSIS-CLINICAL

Neurology

MULTIPLE SCLEROSIS-CLINICAL

1. Paroxysmal symptoms make up the usual course of early disease (except in chronic progressive cases).

2. Weakness or numbness in 1 or more limbs, tingling of the extremities & tight band-like sensations around the trunk or limbs.

3. Optic neuritis - painful loss of central vision in one or both eyes. With unilateral involvement, Marcus Gunn pupil (RAPD) is evident.

4. Internuclear ophthalmoplegia - lesion of the MLF. Difficulty in moving eyes horizontally (adduction paresis), but convergence is intact.

5. Acute myelitis - rapidly evolving (hours or days) symmetrical or asymmetrical paraparesis or paraplegia, ascending paresthesia, sensory level on the trunk, sphincter disturbance and up-going plantars.

6. Others - fatigue, nebulous sensory abnormalities, vertigo/diplopia, ataxic gait, and bowel/ bladder dysfunction, Lhermitte sign, cognitive impairment.

7. Symptoms worsen in the heat (Uhthoff phenomenon) as heat increases conduction block in demyelinated pathways.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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