<prompt> The most common clinical manifestation of Multiple Sclerosis isIntemuclear OphthalmoplegiaAtaxiaOptic NeuritisDiplopia  <response>: C Optic Neuritis INITIAL SYMPTOMS OF MULTIPLE SCLEROSISSymptomPercent of CasesSymptomPercent of Cases Sensory loss37 Lhermitte3 Optic neuritis36 Pain3 Weakness35 Dementia2 Paresthesias24 Visual loss2 Diplopia15 Facial palsy1 Ataxia11 Impotence1 Vertigo6 Myokymia1 Paroxysmal attacks4 Epilepsy1 Bladder4 Falling1 Optic neuritis is the commonest presenting feature of multiple sclerosis out of the given choices. It is roughly seen in 36 of cases. Sensory loss may be the initial symptom in 37 cases. Optic neuritis generally presents as decreased acuity, dimness or colour desaturation in central field of vision. Afferent pupillary response may be detected. Internuclear not intranuclear ophthalmoplegia consists of slow adduction of one eye with nystagmus in the abducting eye. Impaired adduction is due to lesion in medial longitudinal fasciculus. Bilateral internuclear ophthalmoplegia is highly suggestive of multiple sclerosis. Lhermittes symptom sensation of electric shock on flexion of neck is seen in multiple sclerosis. Seizure and aphasia are uncommon in multiple sclerosis. Afferent pupillary defect is seen in multiple sclerosis. There is abnormality in visual evoked potential. MRI helps in confirming the diagnosis. 