http://www.eastafricaneuroscience.com/

East Africa Neuroscience Services, Kisii Galaxy Medicare Centre, Kisii (2026)

10/04/2026

10/04/2026

MULTIPLE SCLEROSIS (MS) — Clinical Features

🔹 High-yield disease pattern
• Autoimmune CNS demyelinating disease (brain + spinal cord)
• Symptoms come in episodes (relapses) with partial recovery (remissions)
• Key concept: lesions disseminated in time and space (different CNS locations, different times)

🔹 Visual symptoms (very common early clue)
• Optic neuritis: painful eye movement + blurred vision
• Reduced color vision (red desaturation)
• Usually unilateral
• May have a central scotoma

🔹 Brainstem / ocular motility clues
• Diplopia (double vision)
• Internuclear ophthalmoplegia (INO): impaired adduction of one eye with abducting nystagmus of the other
• Nystagmus may occur

🔹 Sensory symptoms
• Numbness, tingling, “pins and needles” (paresthesias)
• Sensory loss can involve face, arm, trunk, or leg
• Electric/burning sensations may occur

🔹 Motor (UMN) findings
• Limb weakness
• Spasticity
• Hyperreflexia and clonus may be present
• Extensor plantar response (Babinski) may occur

🔹 Cerebellar / gait signs
• Ataxia and unsteady gait
• Tremor and incoordination (intention tremor)
• Poor balance and frequent stumbling

🔹 Bladder and bowel symptoms
• Urinary urgency and frequency
• Urge incontinence
• Incomplete emptying/retention can occur
• Constipation may occur

🔹 Fatigue and cognition
• Fatigue is very common and can be disabling
• Mild cognitive slowing, poor attention, “brain fog” may occur
• Symptoms may fluctuate day to day

🔹 Classic bedside clues
• Lhermitte sign: electric shock-like sensation down the spine with neck flexion (cervical cord involvement)
• Uhthoff phenomenon: heat/exercise temporarily worsens symptoms (hot bath, fever, summer heat)

🔹 High-yield investigations
• MRI brain/spine: demyelinating plaques (often periventricular; “Dawson’s fingers” pattern may be seen)
• CSF oligoclonal bands / ↑ IgG index supports diagnosis
• Evoked potentials may show slowed conduction

🔹 When to seek urgent help
• Sudden severe vision loss, new significant weakness, inability to walk
• New trouble breathing/swallowing, severe dizziness with falls
• New bladder retention with severe back/leg weakness
• New neuro symptoms with fever or severe headache

Medical disclaimer: This is for education only and not a diagnosis. New neurologic symptoms (vision loss, weakness, severe imbalance, bladder retention) need prompt medical evaluation. If symptoms are sudden/severe, go to emergency care.