A nurse is caring for a client who has multiple sclerosis and reports a tightening feeling around their torso. Which of the following conditions should the nurse recognize this finding indicates?

A. Difficulty initiating speech

This is a characteristic symptom of expressive aphasia. Individuals with expressive aphasia have difficulty initiating speech and may produce speech that is slow, effortful, and lacking in grammatical structure.

B. Difficulty understanding the written and spoken word

This symptom is not typically associated with expressive aphasia. Instead, difficulty understanding language, both written and spoken, is more commonly seen in receptive aphasia, also known as Wernicke's aphasia.

C. Total inability to communicate

While expressive aphasia can severely impair verbal communication, it does not result in a total inability to communicate. Individuals with expressive aphasia may still be able to communicate to some extent using nonverbal means, gestures, or writing.

D. Stuttering and spitting

Stuttering and spitting are not characteristic symptoms of expressive aphasia. Stuttering is a speech disorder characterized by interruptions in the flow of speech, while spitting is not typically associated with aphasia.

A. Lhermitte's sign:

Lhermitte's sign is a neurological symptom characterized by a sensation of electric shock-like pain that radiates down the spine and into the limbs, typically triggered by flexing the neck forward. It is often described as shooting or stabbing pain and is commonly associated with lesions or damage to the cervical spinal cord. Lhermitte's sign is not associated with a tightening sensation around the torso but rather with shooting pain down the spine and limbs.

B. Trigeminal neuralgia:

Trigeminal neuralgia is a neurological condition characterized by severe, shooting pain along the trigeminal nerve, which supplies sensation to the face. The pain is typically triggered by activities such as chewing, speaking, or touching the face. Trigeminal neuralgia causes sudden, intense, electric shock-like pain in the face, particularly in the areas supplied by the trigeminal nerve (e.g., cheek, jaw, forehead). It is not associated with a tightening sensation around the torso.

C. MS hug:

The "MS hug" is a symptom experienced by some individuals with multiple sclerosis, characterized by a sensation of tightness, pressure, or squeezing around the chest, abdomen, or torso. It can feel like a band tightening around the body and may be described as a constricting or girdling sensation. The MS hug is caused by spasms or tightening of the muscles surrounding the rib cage or the intercostal muscles due to damage to the nerves that control muscle function in MS.

D. Paroxysmal spasms:

Paroxysmal spasms refer to sudden, involuntary muscle contractions or spasms that occur intermittently. These spasms can affect various parts of the body and are commonly associated with conditions like multiple sclerosis. However, they typically present as brief, sudden contractions rather than a persistent tightening sensation around the torso.