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Chapter 2 - Clinical Features of Multiple Sclerosis

Published online by Cambridge University Press:  10 February 2021

Carlos A. Perez
Affiliation:
University of Texas, Houston
Andrew Smith
Affiliation:
OhioHealth Riverside Methodist Hospital in Columbus, Ohio, USA
Flavia Nelson
Affiliation:
University of Minnesota, Minneapolis
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Summary

Multiple sclerosis (MS) is a chronic, immune-mediated, inflammatory/demyelinating disease of the central nervous system (CNS).1 Although certain clinical features are characteristic of MS, its manifestations can be highly variable among patients.2 This chapter discusses the diagnostic approach and clinical features of MS, as well as specific features (red flags) that should alert the clinician to the possibility of diseases other than MS (“MS mimics”).

Type
Chapter
Information
Multiple Sclerosis
A Practical Manual for Hospital and Outpatient Care
, pp. 21 - 36
Publisher: Cambridge University Press
Print publication year: 2021

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References

Tillery, EE, Clements, JN, Howard, Z. What’s new in multiple sclerosis? Ment Heal Clin. 2017;7(5):213–20. doi:10.9740/mhc.2017.09.213Google ScholarPubMed
Krieger, SC, Minneap, C, June, M, Sclerosis, M. New approaches to the diagnosis, clinical course, and goals of therapy in multiple sclerosis and related disorders. Continuum (Minneap Minn). 2016;22(3):723–9. doi:10.1212/CON.0000000000000324Google Scholar
Geraldes, R, Ciccarelli, O, Barkhof, F, et al. The current role of MRI in differentiating multiple sclerosis from its imaging mimics. Nat Rev Neurol. 2018;14(4):199213. doi:10.1038/nrneurol.2018.14Google Scholar
McDonald, WI, Compston, A, Edan, G, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the International Panel on the Diagnosis of Multiple Sclerosis. Ann Neurol. 2001;50(1):121–7. doi:10.1002/ana.1032Google Scholar
Olek, MJ. Differential diagnosis, clinical features, and prognosis of multiple sclerosis. In: Curr Clin Neurol Mult Scler. 2005:15–53.CrossRefGoogle Scholar
Filippi, M, Preziosa, P, Meani, A, et al. Prediction of a multiple sclerosis diagnosis in patients with clinically isolated syndrome using the 2016 MAGNIMS and 2010 McDonald criteria: a retrospective study. Lancet Neurol. 2018;17(2):133–42. doi:10.1016/S1474-4422(17)30469-6Google Scholar
Palace, J. Making the diagnosis of multiple sclerosis. J Neurol Neurosurg Psychiatry. 2001;71(suppl II):ii3ii8. www.ncbi.nlm.nih.gov/pubmed/16400830.Google ScholarPubMed
Carroll, WM. 2017 McDonald MS diagnostic criteria: evidence-based revisions. Mult Scler J. 2018;24(2):92–5. doi:10.1177/httpsGoogle Scholar
Mowry, EM, Deen, S, Malikova, I, et al. The onset location of multiple sclerosis predicts the location of subsequent relapses. J Neurol Neurosurg Psychiatry. 2009;80(4):400–3. doi:10.1136/jnnp.2008.157305Google ScholarPubMed
Brownlee, WJ, Hardy, TA, Fazekas, F, Miller, DH. Diagnosis of multiple sclerosis: progress and challenges. Lancet. 2017;389:1336–46. doi:10.1016/S0140-6736(16)30959-XCrossRefGoogle ScholarPubMed
Reich, DS, Lucchinetti, CF, Calabresi, PA. Multiple sclerosis. N Engl J Med. 2018;378(2):169–80. doi:10.1056/NEJMra1401483Google Scholar
Hollenbach, JA, Oksenberg, JR. The immunogenetics of multiple sclerosis: a comprehensive review. J Autoimmun. 2015;64:1325. doi:10.1016/j.clinbiochem.2015.06.023.Gut-LiverCrossRefGoogle ScholarPubMed
Hacohen, Y, Wong, YY, Lechner, C, et al. Disease course and treatment responses in children with relapsing myelin oligodendrocyte glycoprotein antibody–associated disease. JAMA Neurol. 2018;75(4):478–87. doi:10.1001/jamaneurol.2017.4601Google Scholar
Cree, BAC, Gourraud, PA, Oksenberg, JR, et al. Long-term evolution of multiple sclerosis disability in the treatment era. Ann Neurol. 2016;80(4):499510. doi:10.1002/ana.24747Google Scholar
Coyle, PK. Symptom management and lifestyle modifications in multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):815–36. doi:10.1212/CON.0000000000000325Google Scholar
Marcus, JF, Waubant, EL. Updates on clinically isolated syndrome and diagnostic criteria for multiple sclerosis. Neurohospitalist. 2013;3(2):6580. doi:10.1177/1941874412457183Google Scholar
Gafson, A, Giovannoni, G, Hawkes, CH. The diagnostic criteria for multiple sclerosis: from Charcot to McDonald. Mult Scler Relat Disord. 2012;1(1):914. doi:10.1016/j.msard.2011.08.002CrossRefGoogle ScholarPubMed
Tremlett, H, Zhao, Y, Rieckmann, P, Hutchinson, M. New perspectives in the natural history of multiple sclerosis. Neurology. 2010;74(24):2004–15. doi:10.1212/WNL.0b013e3181e3973fGoogle Scholar
Confavreux, C, Vukusic, S. Natural history of multiple sclerosis. Brain. 2006;129(3):606–16. doi:10.1093/brain/awl007CrossRefGoogle ScholarPubMed
Okuda, DT, Mowry, EM, Beheshtian, A, et al. Incidental MRI anomalies suggestive of multiple sclerosis. Neurology. 2009;72(9):800–5. doi:10.1212/01.wnl.0000335764.14513.1aGoogle Scholar
Krieger, SC. New approaches to the diagnosis, clinical course, and goals of therapy in multiple sclerosis and related disorders. Continuum (Minneap Minn). 2016;22(3):723–9. doi:10.1212/CON.0000000000000324Google Scholar
Wingerchuk, DM. Immune-mediated myelopathies. Continuum (Minneap Minn). 2018;24(2):497522. doi:10.1212/CON.0000000000000582Google Scholar
Thompson, AJ, Banwell, BL, Barkhof, F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. Lancet Neurol. 2018;17(2):162–73. doi:10.1016/S1474-4422(17)30470-2Google ScholarPubMed
Gelfand, JM. Multiple Sclerosis: Diagnosis, Differential Diagnosis, and Clinical Presentation. Vol 122. Goodin, DS, ed. Amsterdam: Elsevier; 2014. doi:10.1016/B978-0-444-52001-2.00011-XGoogle Scholar
Freedman, MS, Rush, CA. Severe, highly active, or aggressive multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):761–84. doi:10.1212/CON.0000000000000331Google Scholar
Thompson, AJ, Baranzini, SE, Geurts, J, et al. Multiple sclerosis. Lancet Neurol. 2018;391:1622–36. doi:10.1016/B978-0-7234-3748-2.00015-3Google Scholar
Miller, DH, Chard, DT, Ciccarelli, O. Clinically isolated syndromes. Lancet Neurol. 2012;11:157–69.Google Scholar
Polman, CH, Reingold, SC, Banwell, B, et al. Diagnostic criteria for multiple sclerosis: 2010 Revisions to the McDonald criteria. Ann Neurol. 2011;69(2):292302. doi:10.1002/ana.22366CrossRefGoogle Scholar
Feinstein, A, Freeman, J, Lo, AC. Treatment of progressive multiple sclerosis: what works, what does not, and what is needed. Lancet Neurol. 2015;14(2):194207.Google Scholar
Willis, MA, Fox, RJ. Progressive multiple sclerosis. Continuum (Minneap Minn). 2016;22(3):785–98. doi:10.1007/978-1-4471-2395-8Google Scholar
Koch, M, Kingwell, E, Rieckmann, P. The natural history of primary progressive multiple sclerosis. Neurology. 2009;73(23):19962002. doi:10.1212/WNL.0b013e3181c5b47fGoogle Scholar
Sorte, DE, Poretti, A, Newsome, SD, et al. Longitudinally extensive myelopathy in children. Pediatr Radiol. 2015;45(2):244–57. doi:10.1007/s00247-014-3225-4CrossRefGoogle ScholarPubMed
Filippi, M, Rocca, MA, Benedict, RHB, et al. The contribution of MRI in assessing cognitive impairment in multiple sclerosis. Neurology. 2010;75(23):2121–8. doi:10.1212/WNL.0b013e318200d768Google Scholar
Yamout, B, Al Khawajah, M. Radiologically isolated syndrome and multiple sclerosis. Mult Scler Relat Disord. 2017;17:234–7. doi:10.1016/j.msard.2017.08.016CrossRefGoogle ScholarPubMed
van Munster, CEP, Jonkman, LE, Weinstein, HC, et al. Gray matter damage in multiple sclerosis: impact on clinical symptoms. Neuroscience. 2015;303:446–61. doi:10.1016/j.neuroscience.2015.07.006Google Scholar
Tornes, L, Conway, B, Sheremata, W. Multiple sclerosis and the cerebellum. Neurol Clin. 2014;32:957–77.CrossRefGoogle ScholarPubMed

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