BOSTON—Radiologically isolated syndrome (RIS) may be the first visible manifestation of
multiple sclerosis (MS), according to an overview
that was presented at the 2014 Joint ACTRIMS–
ECTRIMS Meeting.
Not all neurologists accept RIS as a valid and distinct entity, however. Providing a firm, scientific basis for the diagnosis may require improved characterization of the syndrome and the lesions that define it.
An important question for researchers to answer
is whether MS, similar to diseases such as high blood
pressure, high cholesterol, and diabetes, should be
treated early (eg, at RIS onset) to improve disabil-
ity over time, said Darin T. Okuda, MD, Associate
Professor of Neurology and Neurotherapeutics at the
University of Texas Southwestern in Dallas. “We defi-
nitely need more scientific studies to answer this very
important question: Would earlier treatment result in
better long-term outcomes for patients?”
What Is RIS?
A diagnosis of RIS may result from an MRI ordered
to investigate a complaint unrelated to MS. “For the
most part, these are individuals who were being
worked up for migraine headache complaints, cerebrovascular accidents, [and] post-traumatic events,”
said Dr. Okuda. A neurologist may diagnose RIS
when the MRI reveals features within the brain and
spinal cord that strongly suggest MS. Such features
include periventricular, ovoid, circumscribed lesions
within the cervical and thoracic spinal cord.
November 2014
Volume 22, Number 11
Does MS Begin With
Radiologically Isolated Syndrome?
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