Fast Five Quiz: Multiple Sclerosis Diagnosis and Workup

Christopher Luzzio, MD


November 22, 2022

A variety of abnormal physical findings may be seen in a patient with MS, and these findings may vary from examination to examination. Increased tone or stiffness in the extremities, with velocity-dependent passive range of motion, is a common finding. Hyperreactive reflexes with clonus in the ankles and upgoing toes, localized weakness, and impaired gait and coordination are also common physical findings.

A cervical cord lesion can cause Lhermitte's phenomenon, which presents with an electric shock-like sensation down the neck and back on flexing the neck. This can be a useful diagnostic clue.

Unilateral optic neuritis, characterized by gradual-onset monocular visual loss, pain on eye movement, and distorted color vision, is a common first presentation of relapsing-remitting MS, the most common type of MS.

Learn more about diagnostic considerations in MS.


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