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Assessment and Diagnosis of Relapsing Multiple Sclerosis

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Handbook of Relapsing-Remitting Multiple Sclerosis

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Abstract

Various iterations of diagnostic criteria for MS have been proposed over the years, but the underlying principle of diagnosing relapsing–remitting MS (RRMS) has remained the same, requiring evidence of disease dissemination at various time points and in various parts of the central nervous system (dissemination in time and space). Criteria for dissemination can be fulfilled either by clinical relapses or, more recently, by characteristic MRI abnormalities, although in all cases patients must have experienced at least one clinical relapse. Although MRI has largely replaced the use of CSF and evoked potential testing in the explicit diagnostic criteria, paraclinical testing may be useful for ruling out alternative disease etiology, and, indeed, diagnostic criteria require that no better explanation for the neurologic symptoms be available. The extent of additional testing needed to ensure that no better explanation is available is highly case dependent. Depending on the nature of the presenting symptoms and imaging findings the differential diagnosis may include infectious, vascular, neoplastic, genetic, and toxic/metabolic diseases as well as other non-MS idiopathic demyelinating disease such as neuromyelitis optica (NMO) and acute disseminated encephalomyelitis (ADEM). Once a diagnosis is established, various assessment scales including the Kurtzke Expanded Disability Status Scale (EDSS) and the Multiple Sclerosis Functional Composite (MSFC) can be used to monitor disability levels for both clinical and research purposes.

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Author information

Authors and Affiliations

  1. MS Clinical Care and Research Center, Department of Neurology, Columbia University Medical Center, New York, NY, USA

    Rebecca Straus-Farber

  2. Corinne Goldsmith Dickinson Center for Multiple Sclerosis, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Aaron Miller

Authors
  1. Rebecca Straus-Farber
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  2. Aaron Miller
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Correspondence to Aaron Miller .

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Editors and Affiliations

  1. Icahn School of Medicine at Mount Sinai, New York, USA

    Aaron Miller

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Straus-Farber, R., Miller, A. (2017). Assessment and Diagnosis of Relapsing Multiple Sclerosis. In: Miller, A. (eds) Handbook of Relapsing-Remitting Multiple Sclerosis. Adis, Cham. https://doi.org/10.1007/978-3-319-40628-2_3

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  • DOI: https://doi.org/10.1007/978-3-319-40628-2_3

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  • Publisher Name: Adis, Cham

  • Print ISBN: 978-3-319-40626-8

  • Online ISBN: 978-3-319-40628-2

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