Overview
Signs of Multiple Sclerosis
- Signs of optic neuritis - reduced visual acuity, central visual loss, optic disc atrophy
- Internuclear ophthalmoplegia - inability to adduct one eye, with nystagmus in the other eye
- Lhermitte's sign - electric sensation in the limbs on neck flexion
- Upper motor neuron weakness - increased tone, reduced power, hyperreflexia
- Dorsal column (vibration / proprioception) sensory loss
- Signs of cerebellar involvement - ataxia, dysarthria, dysmetria, dysdiadochokinesis, nystagmus
Lhermitte's Sign
How to Perform
- Flex the patient's neck and ask them about any symptoms in their back, arms or legs.
Interpretation
- Lhermitte's sign is present if there is an electric shock-like sensation through the back and down the upper / lower limbs.
Significance
- Classically a sign of multiple sclerosis, though can occur with other myelopathies, chemotherapy or radiotherapy.
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