Clinical Presentation and Additional
Data Needed for MS Diagnosis
• Two or more attacks
• Objective clinical
evidence of 2 or more lesions with reasonable historical evidence of a prior
attack. None; clinical evidence
will suffice. Additional evidence (eg, brain MRI) desirable, but must be
consistent with MS
• Two or more attacks
• Objective clinical
evidence of 1 lesion. dissemination
in space demonstrated by MRI or Await further clinical attack implicating a
different site
• One attack
• Objective clinical
evidence of 2 or more lesions. Dissemination
in time demonstrated by MRI or second clinical attack
• One attack
• Objective clinical
evidence of 1 lesion (clinically isolated syndrome). Dissemination in space demonstrated by MRI or await a
second clinical attack implicating a different CNS site and dissemination in
time, demonstrated by MRI or second clinical attack
• Insidious neurologic progression suggestive of MS One year of disease progression and dissemination in space,
demonstrated by 2 of the following:
• One or more T2 lesions in
brain, in regions characteristic of MS
• Two or more T2 focal
lesions in spinal cord
• Positive CSF
An attack is defined as a neurologic disturbance of the kind seen in MS. It
can be documented by subjective report or by objective observation, but it must
last for at least 24 hours. Pseudoattacks and single paroxysmal episodes must
be excluded. To be considered separate attacks, at least 30 days must elapse
between onset of one event and onset of another event.
