National Physical Therapy Examination (NPTE) Practice Exam

Which of the following symptoms is least likely to be expected in a patient with multiple sclerosis?

1. Ataxia

2. Optic neuritis

3. Trigeminal neuritis

4. Electric shock-like sensation with neck extension

The correct answer is: Electric shock-like sensation with neck extension

In the context of multiple sclerosis (MS), the symptoms experienced can vary significantly among patients due to the nature of the disease, which involves the demyelination of nerves in the central nervous system. The symptom characterized by an "electric shock-like sensation with neck extension" is known as Lhermitte’s sign. While Lhermitte's sign can occur in MS, it is not as commonly recognized or generalized among patients as other symptoms. Ataxia is often observed in MS due to damage to the cerebellum or its connecting pathways, leading to difficulties with balance and coordination. Optic neuritis is a hallmark symptom associated with MS, presenting as vision problems stemming from inflammation of the optic nerve. Trigeminal neuritis, or trigeminal neuralgia, can also occur in MS due to demyelination affecting the cranial nerve responsible for facial sensation, causing severe facial pain. Considering the commonality and presentation of these symptoms in MS, the electric shock-like sensation, while notable, is less frequently reported compared to ataxia, optic neuritis, and trigeminal neuritis. Therefore, it's categorized as the least likely symptom to be expected in a patient with multiple sclerosis.