Clinical Practice Guideline of Clinically Isolated Syndrome: Part II. Management and Monitoring
Jeeyoung Oh1*, Joong-Yang Cho2*, Sa Yoon Kang3, Nam-Hee Kim4, Sun-Young Kim5, Sung-Min Kim6, Su-Hyun Kim7, Jee Young Kim8, Tai-seung Nam9, Min Su Park10, Ha Young Shin11, Jung Hee Cho12, So-Young Huh13, Woojun Kim14, Ju-Hong Min15†, Ohyun Kwon16†
1Department of Neurology, Kunkuk University Hospital, Kunkuk University School of Medicine, 2Department of Neurology, Ilsan Paik Hospital, Inje University College of Medicine, 3Department of Neurology, Jeju National University Hospital, Jeju University Co
Clinically isolated syndrome (CIS) is the typical first clinical episode that is highly suggestive of multiple
sclerosis (MS). Without diagnostic marker, diagnosing CIS is exactly alike diagnosing MS with
even less evidences and requires careful and integrative interpretation of clinical, radiological and
immunological findings. In the aspect of management, numerous clinical trials and cohort studies
strongly support prompt start of disease modifying therapies even in the stage of CIS to prevent disability
accumulation with disease activity. This guideline covers sequential stages of clinical practice
- encounter, assessment, diagnosis, and management - and addresses their principal evidences to
help clinicians make correct diagnosis and proper management. Though it cannot be emphasized
too much to consider every possible differential diagnosis other than MS thoroughly when we encounter
patients with CIS, the details regarding differential diagnosis are out of the scope of this
guideline. The guideline would be regularly updated and revised every a few years to serve its role.
Journal of Multiple Sclerosis 7(2):40-48, 2016
