Multiple sclerosis: The Daily PANCE Blueprint
A patient experiences short, intense, electric-shock-like sensations that pass down from their neck/spine to their limbs. It happens when they flex their neck. What is this finding known as?
A. Lhermitte sign
B. Uhthoff's phenomenon
C. Brudzinski's sign
D. Raynaud’s phenomenon
E. None of the above
Answer and topic summary
The answer is A. Lhermitte sign
Multiple sclerosis is a demyelinating disease of the central nervous system. There are various types of MS phenotypes and patterns. Clinical features that are suggestive of multiple sclerosis include sensory loss in limbs or one side of face, gait/balance issues, fatigue, heat sensitivity (Uhthoff), Lhermitte sign, internuclear ophthalmoplegia, optic neuritis.
MRI of the brain (+/- spinal cord) is the diagnostic test of choice. The McDonald diagnostic criteria can be used to help make the diagnosis of MS; however, it is NOT meant to rule out other neurological conditions. Treatment of MS includes disease-modifying pharmacotherapy, such as glatiramer acetate (Copaxone), dimethyl fumarate, natalizumab (Tysabri), interferons, and many more. Acute exacerbations of MS are managed with short-term, high-dose glucocorticoids.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Neurology ⇒ ⇒
Also covered as part of the Internal Medicine EOR topic list
