Multiple Sclerosis—From Probable to Definite Diagnosis

Abstract
THE FIRST appearance of various combinations of motor, sensory, coordination, visual, and cognitive impairments, as well as symptoms of fatigue and urinary tract dysfunction compatible with central nervous system (CNS) involvement in young patients, raises the possibility of multiple sclerosis (MS).1 The gradual resolution of these symptoms during a period of days to weeks further supports this diagnostic entity. In the last decade, extensive use of electrophysiologic studies, brain and spinal cord imaging, and immunologic parameters has contributed immensely to early diagnosis of MS.2,3 However, the diagnostic algorithm still requires that definite MS be clinically diagnosed only when the second neurologic relapse occurs.4 Thus, between the first and second relapse, patients are classified as having probable MS.

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