How accurate is the first attack and MRI findings so that the diagnosis of MS is given? If negative then what?
MS is a clinical diagnosis supplemented by laboratory findings like MR imaging and spinal fluid analysis. The diagnosis can only be made after the first attack in a person with acute and chronic abnormalities on MRI consistent with certain specificity criteria. Acute lesions are currently defined by the presence of enhancement after the administration of gadolinium. If there are no enhancing lesions at onset, the current diagnostic criteria does not allow a definite diagnosis of MS.
Revere (Rip) Kinkel MD
Director of the Multiple Sclerosis Program
Professor of Clinical Neurosciences
University of California San Diego