The point at which MS can be diagnosed has been under debate, according to guideline author Elliot Frohman, MD, PhD, of the University of Texas Southwestern Medical School in Dallas.

"Before, the criteria used to diagnosis people required neurologists to show that disease activity had occurred in the brain over time," said Frohman. "People would have to wait for a diagnosis. Now that we have evidence showing that early treatment can reduce the entire course of the disease, we really needed to ask the question about how early the diagnosis can be made."

To develop the guideline, the researchers evaluated all of the scientific studies on the topic. They determined that in many cases findings on a single MRI of the brain and spinal cord can be a strong indicator of whether someone will develop MS in the future. The guideline addresses cases where a young to middle-aged adult has a single occurrence of a sign or symptom of MS activity and other possible diagnoses have been ruled out.

MS involves inflammation of the brain and spinal cord. This inflammation leads to lesions, or areas of damage, on the brain and spinal cord. The guidelines outline the number and type of these lesions that, if present, are a strong predictor of the future development of clinically definite MS. For example, a patient with three or more lesions in the white matter area of the brain has a greater than 80-percent likelihood of developing MS within the next seven to 10 years.

"This guideline helps us use MRI to telescope into the future to see what's going to happen with these patients," Frohman said. "The evidence allows us to predict with more certainty who wil
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Contact: Marilee Reu
mreu@aan.com
651-695-2789
American Academy of Neurology
8-Sep-2003