Clinical Practice Guideline of Clinically Isolated Syndrome: Part I. Evaluation and Diagnosis
Su-Hyun Kim1*, Min Su Park2*, Sa Yoon Kang3, Nam-Hee Kim4, Sun-Young Kim5, Sung-Min Kim6, Jee Young Kim7, Tai-seung Nam8, Ju-Hong Min9, Ha Young Shin10, Jeeyoung Oh11, Jung Hee Cho12, Joong-Yang Cho13, So-Young Huh14, Woojun Kim15†, Ohyun Kwon16†
1Department of Neurology, Research Institute and Hospital of National Cancer Center, 2Department of Neurology, Yeungnam Medical Center, Yeungnam University College of Medicine, 3Department of Neurology, Jeju National University Hospital, Jeju University C
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):29-39, 2016
