A to Z of MS Clinically isolated syndrome

Clinically isolated syndrome (CIS) is an individual's first episode of neurological symptoms lasting at least 24 hours and can be an indicator of what may turn out to be multiple sclerosis. It is caused by inflammation or damage to the covering of nerve in one or more sites in the central nervous system (CNS).

Damage may occur in one place (monofocal) resulting in the experience of a single symptom (eg optic neuritis) or more than one place (mutifocal) when multiple symptoms might be experienced (eg incoordination and bladder problems).

Not everyone who experiences CIS will go on to develop MS and for some there may be no further symptoms. However, if MRI findings show brain lesions that are indicative of MS then chances of having further relapses are high.

Current evidence supports early treatment of clinically isolated syndrome with beta interferon to delay conversion to MS in people at high risk. The 2009 ABN prescribing guidelines state that neurologists may consider the use of beta interferon for people within 12 months of a clinically isolated syndrome when MRI evidence predicts a high likelihood of recurrent episodes.

Reference

Frohman EM, et al.
Most patients with multiple sclerosis or a clinically isolated demyelinating syndrome should be treated at the time of diagnosis.
Archives of Neurology 2006;63(4):614-619.
abstract

Association of British Neurologists (ABN)
Revised (2009) guidelines for prescribing in multiple sclerosis.
London; ABN: November 2009.
download (pdf 124kb)

Return to index