title: Clinically isolated syndromes suggestive of multiple sclerosis, part I: natural history, pathogenesis, diagnosis, and prognosis.
abstract: In 85% of young adults with multiple sclerosis (MS), onset is a subacute clinically isolated syndrome (CIS) of the optic nerves, brainstem, or spinal cord. Methods of assessing the prognosis for patients who present with a CIS have been sought, because only 30-70% of patients with a CIS develop MS. When clinically silent brain lesions are seen on MRI, the likelihood of developing MS is high. MS can be diagnosed within 3 months of CIS presentation with certain MRI and CSF criteria. Disability from MS is less likely in patients with a CIS of optic neuritis or sensory symptoms only, few or no MRI lesions, a long period to the first relapse, and no disability after the first 5 years. Development of more reliable prognostic markers will enable new treatments to be targeted for those who are most likely to benefit. We encourage continued clinical and laboratory assessment of patients with a CIS.
authors.affiliation: MS NMR Research Unit, Institute of Neurology, University College London, London, UK. d.miller@ion.ucl.ac.uk <d.miller@ion.ucl.ac.uk>
authors.forename: David
authors.initials: D
authors.lastname: Miller
authors.forename: Frederik
authors.initials: F
authors.lastname: Barkhof
authors.forename: Xavier
authors.initials: X
authors.lastname: Montalban
authors.forename: Alan
authors.initials: A
authors.lastname: Thompson
authors.forename: Massimo
authors.initials: M
authors.lastname: Filippi
mesh_terms: D000328:Adult; D015415:Biomarkers; D002490:Central Nervous System / Q000473:pathology / Q000503:physiopathology*; D042241:Early Diagnosis; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000592:standards; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology*; D009902:Optic Neuritis / Q000175:diagnosis; D011379:Prognosis; D012008:Recurrence; D013577:Syndrome
chemical_list: D015415:Biomarkers