Clinically isolated syndrome

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By Elizabeth Hartman MD

A clinically isolated syndrome is a first episode of central nervous system dysfunction due to inflammatory demyelination. Risk factors for conversion to clinically definite multiple sclerosis have been identified, and treatment of high-risk individuals may delay subsequent relapses. In this article, Dr. Elizabeth Hartman of CNOS summarizes the diagnosis, evaluation, and prognostic implications of clinically isolated syndromes.

Key points

  • Clinically isolated syndromes such as optic neuritis, transverse myelitis, and other syndromes compatible with a first episode of CNS demyelination warrant prompt evaluation to determine underlying etiology.
  • Clinically isolated syndrome evaluation may yield important prognostic information regarding risk of multiple sclerosis, or may reveal an alternative diagnosis.
  • Early treatment of select clinically isolated syndrome patients may delay subsequent relapses and eventual conversion to clinically definite multiple sclerosis.
  • The newly described “radiologically isolated syndrome” may have similar significance to clinically isolated syndromes.

In This Article

Historical note and nomenclature
Clinical manifestations
Clinical vignette
Pathogenesis and pathophysiology
Differential diagnosis
Diagnostic workup
Prognosis and complications
References cited