Clinical Manifestations of Multiple Sclerosis

CLinical Manifestations Signs Symptoms Multiple Sclerosis Medical health Treatment Therapy
What are Clinical Manifestations of Multiple Sclerosis?
Clinical Manifestations that appear according to the lesion area affected. There are several signs and symptoms that appear in multiple sclerosis:
a. Digestive and urinary dysfunction
b. The reduced perception of pain, vibration, and position
c. Fatigue and impaired mobility
d. Depression and cognitive or memory impairment
e. Vision and hearing problems
f. Tremor, hyperreflexia, spasticity, and positive Babinsky sign
g. Nystagmus, impaired coordination and balance.

        Neurological symptoms that often occur first in multiple sclerosis is neuritis optics in 14-23 % of patients and more than 50 % of patients have experienced. Symptoms experienced is blurred vision, the white man is usually affects in one eye, whereas in Asia more often in both eyes. On physical examination found that pupillary reflexes are decreased, decreased visual acuity, impaired color perception and central scotoma. Funduscopic examination in the acute phase showed that the optic disc hyperemia but can be normal in the posterior / retrobulbar optics neuritis. While in the chronic phase can be seen optic disc atrophy. In addition to the optics neuritis, most patients complain of pain in the orbit that can arise spontaneously or on a continuous eye movement. In addition there is a unique phenomenon called Uhthofff phenomenon in which symptoms decrease in visual acuity (temporal) are exacerbated by heat or physical exercise. Diplopia may also appear on multiple sclerosis although less frequently than neuritis optics

        Sensory disturbances are early clinical manifestations that are often experienced by 21-55 % of patients with multiple sclerosis. General symptoms such as numbness (hypoesthesia), tingling (paresthesia), burning sensation (dysesthesia) and hyperesthesia. The disorder can occur in one or more extremities, and on the body or face. Additionally proprioception, vibration sense and two-point discrimination can also be disrupted causing trouble writing, typing or buttoning a shirt. The proprioceptive symptoms generally arise when there is a bilateral and regional lemniscus lesions in the proprioceptive disorder called just about arm useless hand syndrome. The symptoms are generally experienced remission within a few months. Signs that often occurs in patients with multiple sclerosis are characteristic although Lhermitte sign: if the head is passively flexed, paresthesias arising along the shoulders, back and arms. This may be due to the demyelinating axons, increased sensitivity to pressure to spinal , which is caused by flexion of the head.

        Cerebellar disorders are also common in multiple sclerosis although rarely the main symptoms. Clinical manifestations: cerebellar ataxia, both the fine motor movements (dysmetria, dysdiadochokinesia, intention tremor), gait, and articulation (scanning speech, dysarthria). Moreover, it can also occur nystagmus, especially the bidirectional horizontal, and vertical.

      Hemiparesis caused by corticospinal lesions can occur in multiple sclerosis despite a smaller frequency. Similarly, lesions in the spinal cord can cause Brown-Sequard syndrome or transverse myelitis resulting in paraplegia (generally not symmetrical), sensory level and urinary-defecation disorders. Pathological reflexes and / or bilateral hyperreflexia with or without motor weakness is a manifestation of a more frequent and a sign of bilateral corticospinal lesion. Characteristic, although weakness on one side only, pathological reflexes is always bilateral. Spasticity can cause symptoms of muscle cramps in patients with multiple sclerosis. Tiredness/fatigue is a nonspecific symptom in multiple sclerosis and occurs in almost 90% of patients with multiple sclerosis. Fatigue can be a physical fatigue during excessive exercise, in hot temperatures or mental retardation.

       Memory impairment may occur in patients with multiple sclerosis. According to Thornton et al study of short-term memory, working memory and long term memory is generally impaired in patients with multiple sclerosis. It also acquired attentional disorders. Irritability and emotional disorders such as pseudobulbar affect in the form of forced laughing or crying forced common in patients with multiple sclerosis caused bilateral hemispheric lesions.

       Other symptoms are more rare include trigeminal neuralgia (bilateral), other disorders in the brain stem in the form of paresis n. peripheral facial (bilateral), hearing loss, tinnitus, vertigo, and very rarely loss of consciousness (stupor and coma)

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