Updates on Clinically Isolated Syndrome and Diagnostic Criteria for Multiple Sclerosis

摘要: Clinically isolated syndrome (CIS) is a central nervous system demyelinating event in time that compatible with the possible future development of multiple sclerosis (MS). Early risk stratification for conversion to MS helps treatment decisions. Magnetic resonance imaging (MRI) currently most useful tool evaluate risk. Cerebrospinal fluid studies and evoked potentials may also be used assess likelihood MS. Four clinical trials evaluating benefits either interferon β (IFN-β) or glatiramer acetate (GA) within first 3 months after high-risk CIS demonstrate decreased rates clinically definite (CDMS) lesser degree MRI progression early treatment. In 3-, 5-, 10-year extension 2 formulations IFN-β, rate CDMS remained meaningful when comparing delayed by median years. Diagnostic criteria have been developed based on follow-up large cohorts provide guidance how utilize activity combination radiographic information diagnose The recent 2010 McDonald simplify requirements dissemination space allow diagnosis from baseline brain if there are both silent gadolinium-enhancing lesions nonenhancing same study. diagnostic require special consideration children at acute disseminated encephalomyelitis (ADEM), older adults who small vessel ischemic disease, ethnic groups more commonly develop neuromyelitis optica (NMO).