Symptoms causing diagnostic confusion

• bladder disturbances, including retention of urine and urgency

• 'useless hand' due to loss of position sense

• trigeminal neuralgia

• psychiatric symptoms

In established disease common symptoms are fatigue, impotence and bladder disturbances.

• 3r unsteaoiness impaired via an diplopia cerebellar sgns » nte-ntion tremor • ataxia c iz ncss fatigue

' 1

1

j

f 1

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bladder urgency incontinente constipation paraparesis band sensations around trunk or limbs bladder urgency incontinente constipation

Fcaturti

UMN legion > one lesion septate times

Fig. 29.4 Basic clinical signs in multiple sclerosis

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