Which symptom is not typical of a multiple sclerosis exacerbation?

• A. Double vision
• B. Scanning speech
• C. Resting tremors
• D. Numbness

Answer: (C)

During an MS exacerbation, symptoms arise from acute demyelination of specific CNS pathways, producing focal deficits that reflect the affected tracts. Double vision comes from involvement of the visual pathways or brainstem, producing diplopia. Scanning speech indicates cerebellar or brainstem involvement that disrupts coordinated speech, giving a slow, segmented cadence. Numbness reflects sensory pathway disruption. Resting tremor, however, points to dysfunction in basal ganglia circuits typical of Parkinsonian disorders; in MS relapses tremor is not a hallmark, and when tremor occurs it is usually an intention tremor that worsens with movement, not present at rest. So resting tremor is not typical of an MS exacerbation.