Which manifestation is most likely to appear initially in a person with multiple sclerosis?

Which manifestation is most likely to appear initially in a person with multiple sclerosis?

• A. Sensory disturbances that include blurred vision and tinnitus
• B. Bradykinesia, rigid muscle tone, tremors, and impaired postural reflexes
• C. Fluctuating weakness of certain skeletal muscle groups
• D. Unpleasant motor and sensory abnormalities (paraesthesias)

Answer: (A)

Early in multiple sclerosis, the optic nerve is commonly affected, leading to optic neuritis. This produces visual changes such as blurred vision, often with eye pain on movement and sometimes double vision. Because vision problems from optic neuritis are a classic first clue to MS, sensory disturbances that include blurred vision represent the most likely initial manifestation. The other descriptions point to signs that are either less typical as an initial presenting feature of MS (for example, Parkinson-like motor changes) or describe symptoms that can occur later or in other conditions, whereas blurred vision from optic neuritis is a classic, defining early feature.

Early in multiple sclerosis, the optic nerve is commonly affected, leading to optic neuritis. This produces visual changes such as blurred vision, often with eye pain on movement and sometimes double vision. Because vision problems from optic neuritis are a classic first clue to MS, sensory disturbances that include blurred vision represent the most likely initial manifestation. The other descriptions point to signs that are either less typical as an initial presenting feature of MS (for example, Parkinson-like motor changes) or describe symptoms that can occur later or in other conditions, whereas blurred vision from optic neuritis is a classic, defining early feature.