Neurological Examination and Guiding Clinicians in the Diagnosis of Multiple Sclerosis: Aliza Ben-Zacharia, PhD, DNP, ANP-BC, FAAN

WATCH TIME: 5 minutes

"Sometimes [diagnosis is] challenging because it's not always a focal area that gives you the signs of the symptoms. It can be multifocal, or it can be diffused like in tumefactive MS lesions or a combination of both. It can be one area and then a few other areas. I think as a clinician, nurse practitioner, physician, MS expert, we have the knowledge that we can apply to all patients and think about the systematic approach [for diagnosis].”

Diagnosing multiple sclerosis is a constant challenge in the field that clinicians may come to face in their clinical practice. The diagnosis can be noted according to symptoms and signs by themselves or even a combination of clinical features presented in the patient. Over time, the criteria for diagnosing MS have evolved, with the most to date version stressing earlier diagnosis intervention in patients that show typical clinical syndromes.¹

Aliza Ben-Zacharia, PhD, DNP, ANP-BC, FAAN, assistant professor at Hunter College, presented on the clinical pearls in MS and the spinal cord in a clinical workshop at the 2023 Consortium of Multiple Sclerosis Centers (CMSC) Annual Meeting, held May 31 to June 3, in Aurora, Colorado. The rest of the clinical course was centered on neuroanatomy for clinicians in MS and featured Stephen Krieger, MD, FAAN, associate professor of neurology at Icahn School of Medicine at Mount Sinai, as he provided expert insights on the brainstem and cranial nerves related to the disease.²

Ben-Zacharia sat down in an interview with NeurologyLive® at the meeting to give a brief overview of the workshop and the main takeaways. She talked about how clinicians can apply a certain approach to localize symptoms and identify their origin from the central or peripheral nervous system. Ben-Zacharia also spoke about the significance of considering upper motor neuron symptoms versus muscle weakness in the neuromuscular junction when localizing the origin of signs. Additionally, she provided an analogy to help clinicians understand lesion localization in the nervous system and the specific functions the locations control.

Click here for more coverage of CMSC 2023.

REFERENCES
1. Oh J. Diagnosis of Multiple Sclerosis. Continuum (Minneap Minn). 2022;28(4):1006-1024. doi:10.1212/CON.0000000000001156
2. Ben-Zacharia A. Introduction and Clinical Pearls. Presented at: 2023 CMSC Annual Meeting; held May 31-June 3; Aurora, CO. CC4.