During an acute relapse of multiple sclerosis, which symptom is most likely?

• A. Vision changes
• B. Seizure activity
• C. Hearing loss
• D. Numbness or weakness in limbs

Answer: (D)

During an acute relapse, multiple sclerosis causes new neurologic deficits from inflammatory demyelination in the central nervous system. The pathways that control movement and sensation in the brain and spinal cord are commonly affected, so numbness or weakness in the limbs is the most frequent presenting symptom of a relapse. Vision changes can occur, often from optic neuritis, but limb numbness or weakness tends to be more commonly reported as the hallmark relapse symptom. Seizure activity and hearing loss are less typical features of an MS relapse; seizures can occur in people with MS but are not characteristic of the usual relapse pattern, and hearing loss is not a common relapse symptom. The symptom pattern reflects lesion location, with motor and sensory pathways most often driving acute limb symptoms.