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Medicine

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Neurology

Question
4 out of 12
 

Uhthoff’s phenomenon is worsening of symptom due to …………? (PNQ)



A Exposure to heat
B Exposure to cold

C Alcohol intake
D None of the above

Ans. A

Exposure to heat

The McDonald criteria are diagnostic criteria for multiple sclerosis (MS).

Currently, McDonald criteria is regarded as the Gold standard for MS diagnosis.

Clinical features –

1). Weakness of limbs – Fatigue, gait disturbance

2). Pyramidal signs – Increase tone, hyperreflexia, extensor plantar.

(Treatment:Baclofen, Dantrolene, Tizanidine)

3). DTR may be lost (lesion at dorsal root entry zone).

4). Optic neuritis – Usually symptoms are monocular, Periorbital pain.

a. Decrease acuity, papillitis, optic atrophy.

b. Diplopia due to inter nuclear ophthalmoplegia.

5). Sensory symptoms – paresthesia, numbness.

Impotency is a feature

6). Ataxia – cerebellum or cerebellar pathway involvement.

7). Bladder dysfunction – Urgency, hesitancy, incontinence

(Treatment: Use oxybutynin or tolterodine if post micturition urine is present).

8). Cognitive dysfunction – Memory loss, impaired attention.

9). Depression – Upto 60% pts. Suicidal tendencies are more.

10). Heat sensitivity (Uhthoff's phenomenon)– Appearance of new symptoms or the worsening of preexisting symptoms on exposure to heat. – Conduction block which may occur in response to increase temperature or metabolic derangements. (Negative conduction abnormalities Q)

11). Lhermitte’s symptom (Barber chair sign) – Generation of ectopic impulse giving rise to Lhermitte’s Sympt, paroxysmal symptoms or paresthesias. (Positive conduction abnormalities Q)

12). Paroxysmal symptoms – Brief and stereotypic. Tonic spasm, dysarthria, ataxia, diplopia, paresthesia, pain.

13). Trigeminal neuralgia Q

14). Facial myokymia

15). Vertigo – of brain stem origin.

Barber chair sign is also seen in:

a. Vit B12 deficiency

b. Cervical spondyloses

Extra Edge:Parkinsonism, Speech aphasia, & epilepsy are the not the feature of multiple sclerosis!!!.

Neurology Flashcard List

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