Unusual symptoms and syndromes in multiple sclerosis

Area of Science:

• Neurology
• Clinical Medicine

Background:

• Multiple sclerosis (MS) presents with diverse symptoms, some well-established and others less commonly recognized.
• Underrecognized MS phenomena can lead to extensive diagnostic workups and inappropriate interventions.

Observation:

• This review covers Lhermitte sign, Pulfrich phenomenon, Uhthoff phenomenon, Oppenheim's useless hand, and transient neurological events like tonic spasms.
• Disorders of temperature regulation, potentially linked to hypothalamic dysfunction in MS, can manifest as unusual behavioral changes.
• Epilepsy and sleep disorders are observed with increased frequency in the MS population.

Findings:

• Specific underrecognized symptoms in MS include Lhermitte sign, Pulfrich phenomenon, Uhthoff phenomenon, Oppenheim's useless hand, and transient neurological events.
• Temperature regulation abnormalities and associated behavioral changes in MS patients often evade diagnosis.
• Increased prevalence of epilepsy and sleep disorders in MS patients requires therapeutic consideration.

Implications:

• Educating clinicians on these underrecognized MS symptoms can improve patient care.
• Timely diagnosis of these phenomena can reduce unnecessary emergency department visits and investigations.
• Better recognition and management of these MS symptoms may lead to more effective therapeutic strategies.