http://link.springer.de/link/service/journals/10072/bibs/1022008/1022s093.htm
Online publication: December 5, 2001
Neurological Sciences
Abstract Volume 22 Issue 8 (2001)
pp S93-S97
C. Gasperini
Multiple Sclerosis Center, Department
of Neuroscience, S. Camillo-Forlanini Hospital, Circonvallazione Gianicolense
87, I-00152 Rome, Italy
Abstract.
Multiple sclerosis can usually be
diagnosed from a patient's history, clinical examination, cerebrospinal
fluid (CSF) analysis, and observations from magnetic resonance imaging
(MRI).
However, sometimes, the classic clinical
criteria, even when supported by MRI findings or by abnormalities of the
CSF, may not be sufficiently specific.
Many conditions can produce a multifocal
central nervous system syndrome with a relapsing-remitting course in young
adults.
The rate of misdiagnosis is around
5%, indicating that 1 in 20 patients thought to have MS have instead a
condition resemling MS.
The need to reach diagnostic certainty
is particularly important given the availability of treatments which may
potentially prevent the progression of the disease.
Therefore, the search for new methodological
approaches which increase the sensitivity and specificity of the diagnosis
is warranted.
While waiting for the development
of new techniques to facilitate an early and correct diagnosis, a correct
approach to a suspect MS patient has to be underlined in order to reduce
the risk of a misdiagnosis.
In this paper, I illustrate the diagnostic
work-up that the practicing physician should follow when first confronted
by a patient suspected of having MS.
© Springer-Verlag Italia 2001