title: CIS case studies.
abstract: The onset of multiple sclerosis presents in 85% of cases as a subacute clinical event, the so-called clinically isolated syndrome. This event involves either focal or multifocal brain regions, most frequently the optic nerve, brainstem or spinal cord. The initial diagnosis of multiple sclerosis necessitates the demonstration of dissemination of pathology in time and space, as well as the exclusion of other alternative diagnoses, and can be challenging. Confirming a diagnosis of multiple sclerosis is a sensitive time for both patient and physician. The patient is faced with a difficult diagnosis and the physician must consider making difficult treatment decisions regarding therapy and follow-up care. This article presents a number of case studies that illustrate the diversity of presentation of clinically isolated syndrome and the challenges associated with confirming a diagnosis of multiple sclerosis.
authors.affiliation: Department of Neurology, University of Ulm, Ulm, Germany. hayrettin.tumani@uni-ulm.de
authors.forename: Hayrettin
authors.initials: H
authors.lastname: Tumani
authors.forename: Irina
authors.initials: I
authors.lastname: Sapunova-Mayer
authors.forename: Sigurd D
authors.initials: SD
authors.lastname: Süssmuth
authors.forename: Valerie
authors.initials: V
authors.lastname: Hirt
authors.forename: Johannes
authors.initials: J
authors.lastname: Brettschneider
mesh_terms: D000328:Adult; D001921:Brain / Q000473:pathology; D003711:Demyelinating Diseases / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D055815:Young Adult