Overview

Features

Patient's with multiple sclerosis (MS) may present with non-specific features, for example around 75% of patients have significant lethargy.

Diagnosis can be made on the basis of two or more relapses and either objective clinical evidence of two or more lesions or objective clinical evidence of one lesion together with reasonable historical evidence of a previous relapse.

Visual

• optic neuritis: common presenting feature
• optic atrophy
• Uhthoff's phenomenon: worsening of vision following rise in body temperature
• internuclear ophthalmoplegia

Sensory

• pins/needles
• numbness
• trigeminal neuralgia
• Lhermitte's syndrome: paraesthesiae in limbs on neck flexion

Motor

• spastic weakness: most commonly seen in the legs

Cerebellar

• ataxia: more often seen during an acute relapse than as a presenting symptom
• tremor