Classic patient has<unk>  presentations for neuro symptoms of different areas of pathology
Patient often has resolution of the earlier symptoms
Symptoms worsen with increases in body temperature, classically after hot showers (Uhthoff's phenomenon)
Muscle/sensory signs:
Lower extremity weakness usually worse than upper extremity
Upper motor neuron signs:
Hyperreflexia
Positive Babinski
Decrease in proprioception/pain/temperature sensation
Lhermitte sign
Electric shock sensation radiating down back into arms/egs from neck flexion
If the discomfort is severe, carbamazepine or gabapentin may be beneficial for some patients.
Optic neuritis
Initial sign in 30% of patients
Vision loss (usually unilateral) often preceded by retrobulbar pain
Blurred vision
Afferent pupillary defect is suggestive of optic neuritis
Nystagmus
Diplopia
Internuclear ophthalmoplegia
Abnormal eye adduction bilaterally and horizontal nystagmus
Convergence (both eyes center medially) is preserved
Dysautonomia
Urinary retention (increased risk of UTI/pyelo)
Constipation or incontinence
Sexual dysfunction (males)
Patient often has resolution of the earlier symptoms
Lower extremity weakness usually worse than upper extremity
Upper motor neuron signs:
Hyperreflexia
Positive Babinski
Decrease in proprioception/pain/temperature sensation
Lhermitte sign
Electric shock sensation radiating down back into arms/egs from neck flexion
If the discomfort is severe, carbamazepine or gabapentin may be beneficial for some patients.
Hyperreflexia
Positive Babinski
Electric shock sensation radiating down back into arms/egs from neck flexion
If the discomfort is severe, carbamazepine or gabapentin may be beneficial for some patients.
Initial sign in 30% of patients
Vision loss (usually unilateral) often preceded by retrobulbar pain
Blurred vision
Afferent pupillary defect is suggestive of optic neuritis
Nystagmus
Diplopia
Abnormal eye adduction bilaterally and horizontal nystagmus
Convergence (both eyes center medially) is preserved
Urinary retention (increased risk of UTI/pyelo)
Constipation or incontinence
Sexual dysfunction (males)
Multiple sclerosis
Neuromuscular weakness
Amyotrophic lateral sclerosis
Upper motor neuron:
Normal pressure hydrocephalus
CVA
Chronic inflammatory demyelinating polyneuropathy
Hemorrhagic stroke