The diagnosis of multiple sclerosis, during its early involvement of the central nervous system, is not an easy task. The early symptoms are chiefly of ophthalmologic interest. The ocular symptoms, such as defects in the visual fields, central scotomas, transitory amblyopias, retrobulbar neuritis, and the objective changes in the optic nerve, as a true papillitis and temporal pallor, demand careful study by the ophthalmologist. The rhinologist is frequently consulted to determine whether or not a causal relation exists between an infected sinus and such visual disturbances, and, especially, whether a retrobulbar neuritis is present. In similar cases the otologist may be called on to interpret the meaning of a possible nystagmus, a dizziness or a true vertigo. The neurologist should note rather early in the course of multiple sclerosis the absence of abdominal reflexes, and the presence of a possible positive Babinski sign which, in connection with the complaint of
HALL GW, GAMBLE RC. EFFECT OF NONSPECIFIC PROTEIN THERAPY ON OCULAR CHANGES IN MULTIPLE SCLEROSIS: PRELIMINARY REPORT. JAMA. 1929;92(4):297–300. doi:10.1001/jama.1929.02700300021005
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