Neurology · UKMLA & AKT
Multiple sclerosis
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise multiple sclerosis — the full SA Note notes add investigations, management, complications and 10 practice questions.
Key high-yield points
- MS causes symptoms from any CNS region; the key pattern is multiple distinct episodes affecting different anatomical locations in a young adult (20-40 years, women 2x more common).
- Optic neuritis - unilateral painful visual loss, reduced colour vision, RAPD; often the first presentation of MS
- Limb weakness - UMN pattern: spastic weakness, brisk reflexes, upgoing plantars
- Sensory disturbance - numbness, tingling, dysaesthesia in dermatomal or cord distribution
- Lhermitte's sign - electric shock down spine into limbs on neck flexion; caused by cervical cord plaque
- Cerebellar features - ataxia, intention tremor, dysarthria, nystagmus
- Bladder dysfunction - urgency, frequency, urge incontinence
- Fatigue and depression - common but fatigue or depression alone without focal neurological symptoms should NOT prompt an MS diagnosis
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