Diagnosis of Multiple Sclerosis

J Korean Neurol Assoc > Volume 23(2); 2005 > Article

Journal of the Korean Neurological Association 2005;23(2): 143-151.

다발성경화증의 진단

김병준, 이광호

성균관대학교 의과대학 삼성서울병원 신경과

Diagnosis of Multiple Sclerosis

Byoung Joon Kim

Department of Neurology, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea

Abstract

Multiple sclerosis (MS) is an immune-mediated, inflammatory demyelinating disease of the central nervous system. The diagnosis mainly depends on the clinical findings and requires the integration of both clinical and paraclinical studies, such as magnetic resonance imaging (MRI). Periodic adjustments in the diagnostic criteria are necessitated by changes in our understanding of disease biology, new technologies, advanced therapeutic modalities, and societal needs for accurate, reliable and early diagnosis. A recent revision of the diagnostic guidelines for MS has been published that formalized the use of MRI information along with the clinical picture. MS in Asian populations is characterized by the selective and severe involvement of the optic nerve and spinal cord as well as low prevalence rates. Although the characteristic clinical features of Asian MS, that is opticospinal MS, vary in opinion as to frequent relapses, severe disability, few brain lesions on MRI, lengthy lesions on spinal cord MRI, pleocytosis and absence of oligoclonal bands. Differential diagnosis of MS is broad. Good history and examination helps to clarify the most likely diagnoses.KeyWords:Multiple sclerosis, Diagnostic criteria, Asian, Differential diagnosis