Identifying numbers "written" on the palms of the hands is the object of the palm-writing test. Two typical patterns of sensory loss are seen in multiple sclerosis (MS). The first is decreased touch or pinprick sensitivity on the legs and trunk up to a particular level, which may be at the navel, at the bottom of the rib cage, up to the nipple line, or as high as the armpits or neck. The exact upper limit of the level pinpoints the lesion to a particular segment of the spinal cord.
The second typical finding is the loss of position sense and stereognosis in the hands. The hands may be normally strong but difficult to use effectively because the patient does not know where the fingers are or what is in the hand without looking. This is called the "useless hands syndrome" and indicates involvement of the cervical (neck) portion of the spinal cord. Frequently, however, the results of the sensory examination are normal in MS, even when the patient is in the midst of a sensory attack.

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Multiple Sclerosis
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