A 30-yeаr-оld client presents tо the neurоlogy clinic for evаluаtion of symptoms that have developed over the past several weeks: Blurred vision in the right eye with pain on eye movement Numbness and tingling in both legs Unilateral weakness in the left arm Persistent fatigue that worsens in the afternoon Difficulty concentrating at work The provider orders a brain and spinal cord MRI and suspects multiple sclerosis (MS). The nurse is reviewing the expected clinical picture with the client. Based on the underlying disease process of MS, which additional cluster of findings should the nurse expect?