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Symptomatology and Diagnosis of Multiple Sclerosis-Reply

Robert G. Hart, MD; David G. Sherman, MD
JAMA. 1982;248(9):1065. doi:10.1001/jama.1982.03330090037019.
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In Reply.—  Our review focused on the role of newer diagnostic investigations in the diagnosis of MS, many of which are unfamiliar to nonneurologists. It was not our purpose to discuss in detail the sensitivity and specificity of symptoms and signs. The symptoms and signs listed in Table 3 were chosen because, in our consulting experience, many clinicians fail to elicit them in MS suspects. Limb weakness, as noted by Dr Poser, is a quite common feature of MS, but is usually a prominent complaint, readily detected by clinicians. We wished to emphasize the inobvious features, less familiar to many clinicians, which occasionally establish the multifocal nature of the illness. Multifocal signs, individually nonspecific, are a hallmark of MS. Thus, we have no real disagreement with Dr Poser's comments except as regards their relevance to our review. Furthermore, it is unclear from Dr Poser's Table if the prevalence of


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