Neurology · UKMLA & AKT
Multiple sclerosis
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
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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