Question

Most common presenting finding of multiple sclerosis is

• A. Internuclear ophthalmoplegia
• B. Optic neuritis
• C. Transverse myelitis
• D. Cerebellar ataxia

Hint:

Think of the ocular symptom that is often the very first sign leading to a multiple sclerosis diagnosis.

Answer 1

The Correct Option is B

Step 1: Understanding the Question:
The question asks which clinical feature most commonly brings a patient with multiple sclerosis to first medical attention.

Step 2: Key Concept or Approach:
Multiple sclerosis is a demyelinating disease that can affect almost any part of the central nervous system, so its presentation is highly variable, but certain sites are affected early and often enough to be the most frequent presenting complaint.

Step 3: Working Through the Options:
Internuclear ophthalmoplegia, from a lesion in the medial longitudinal fasciculus, is a fairly specific and suggestive sign of multiple sclerosis but is not the most common presenting feature. Transverse myelitis, involving the spinal cord, is a recognised presentation but again not the most frequent one. Cerebellar ataxia can occur but is also not the leading presenting symptom. Optic neuritis, inflammation of the optic nerve causing painful vision loss, is the single most common presenting manifestation of multiple sclerosis, and a substantial proportion of patients who present with isolated optic neuritis go on to develop clinically definite multiple sclerosis.

Step 4: Conclusion:
The correct answer is optic neuritis, since it is the most frequent initial presentation of multiple sclerosis.