Multiple Sclerosis

Multiple Sclerosis

  • Clinically Isolated Syndrome (CIS)
Click here for a factsheet on CIS

A clinically isolated syndrome (CIS) is an episode of inflammation in the brain or spinal cord which has not clearly been caused by a new problem such as a viral infection or another condition you are known to have (some diseases such as lupus can cause inflammation in the nervous system).

The commonest cause of a clinically isolated syndrome is a demyelinating process.

This is when the "insulating material" (myelin) around the nerves in the brain or spinal cord is damaged. The commonest cause of demyelination is multiple sclerosis (MS).

Having a single "attack" or CIS does not mean that you have MS.

To make a clinical diagnosis of MS requires two "attacks" at different times and affecting different parts of the nervous system.

There is however a risk of developing MS in the future and research suggests that in people with an MRI scan that does not show other areas of inflammation, the risk of developing MS in the next 10 years is low (about 10%).

In people with an MRI scan that shows previous areas of inflammation the risk of developing MS in the future is higher.

Having had a single episode of inflammation, many people choose to adopt a "wait and see" approach.

There is evidence that disease modifying treatments (DMT's) reduces the chance of having a relapse by about one third and so some people would like to be considered for DMT's.

Under current NICE and ABN guidelines, it would be necessary to demonstrate evidence of further inflammation and so either another clinical event would have to be taken into account.

Another option is to have a second MRI scan after an appropriate interval (3-6 months) in order tolook for a separate area of active inflammation (which may not even be causing symptoms) to area affected on your first scan.

CIS Fact sheet

  • Multiple Sclerosis
Click here to download an MS Factsheet

Multiple sclerosis (MS) is a disease affecting nerves in the brain and spinal cord, causing problems with muscle movement, balance and vision.

Each nerve fibre in the brain and spinal cord is surrounded by a layer of myelin, which protects the nerve and helps electrical signals travel fast and effectively.

In MS, the myelin becomes damaged, MS is a demyelinating inflammatory disorder.

Around 8 out of 10 people with MS will have the relapsing remitting type of MS.

Someone with relapsing remitting MS will have periods of time where symptoms are mild or disappear altogether. This is known as remission and can last for days, weeks or sometimes months.

Remission will be followed by a sudden flare-up of symptoms, known as a relapse. Relapses can last from a few weeks to few months.

Usually after around 10 years, around half of people with relapsing remitting MS will go on to develop secondary progressive MS.

In secondary progressive MS, symptoms gradually worsen and there are fewer or no periods of remission.

The least common form of MS is primary progressive MS. In this type, symptoms gradually get worse over time and there are no periods of remission.

There is currently no cure for MS but there are a number of treatments that can help.

Relapsing remitting MS and secondary progressive MS can be treated with disease-modifying drugs.

These are designed to slow the progression of the disease and reduce the number of relapses. But they are not suitable for all people with MS.

For example at the moment, there is no treatment that can slow the progress of primary progressive MS.

There are also a wide range of treatments, including steroid injections and physiotherapy, that can help relieve symptoms and make day-to-day living easier

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