BMJ  2006;332:668 (18 March), doi:10.1136/bmj.332.7542.668-a

Letter

Diagnosis and treatment of multiple sclerosis

Potential changes in management for clinically isolated episode of optic neuritis

EDITOR—Murray highlights the recent advances in diagnosis and management of multiple sclerosis.¹ This is particularly important in managing a clinically isolated episode of optic neuritis. Current UK ophthalmological management of a unilateral episode of typical optic neuritis is generally not to investigate or to treat.² However, with the development of the McDonald criteria for diagnosing multiple sclerosis and advances in magnetic resonance imaging of lesions,^{3 4} there is potential for early diagnosis of multiple sclerosis.

This is important as new treatments such as recombinant interferon beta-1a may reduce the development of clinically definite multiple sclerosis.⁵ Future best clinical practice in the management of acute optic neuritis may therefore be to investigate all patients to identify those with multiple sclerosis who would benefit from early treatment.

Credit: COMO-UNIQUE/CUSTOM MEDICAL STOCK/SPL

 

pete{at}pdcackett.demon.co.uk Princess Alexandra Eye Pavilion, Edinburgh EH3 9HA

Princess Alexandra Eye Pavilion, Edinburgh EH3 9HA

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Competing interests: None declared

References

1. Murray TJ. Diagnosis and treatment of multiple sclerosis. BMJ 2006;332: 525-7. (4 March.)[Free Full Text]
2. Ghosh A, Kelly SP, Mathews J, Cooper PN, Macdermott N. Evaluation of the management of optic neuritis: audit on the neurological and ophthalmological practice in the north west of England. J Neurol Neurosurg Psychiatry 2002;72: 119-21.[Abstract/Free Full Text]
3. McDonald WI, Compston A, Edan G, Goodkin D, Hartung HP, Lublin FD, et al. Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol 2001;50: 121-7.[CrossRef][ISI][Medline]
4. Magnetic resonance imaging advances in multiple sclerosis. J Neuroimaging 2005;15(suppl): 5-9S.[CrossRef][ISI][Medline]
5. Soderstrom M. Multiple sclerosis: rationale for early treatment. Neurol Sci 2003;24 (suppl 5): S298-300.[Medline]

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Diagnosis and treatment of multiple sclerosis

T J Murray
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