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Treatment of CIS


I have a question regarding my MS and as you are an expert in this field, I would feel it a good idea to seek your knowledge and advice. I believe you had an email from my partner who you kindly advised on the situation of children with someone that has MS. I am very grateful to you for providing her with some of the facts she needed to know. Furthermore, I was initially diagnosed with MS in 1994 and this being the first and single episode of having 'pins and needles' in the tips of 3 fingers at that stage a firm diagnosis could not be made however it was suspected. Subsequently in 2001 had a case of optical neuritis in one eye after a I had been running in winter and suffered a head cold and the optic neuritis was triggered then and lasted approx a week that has since disappeared. Now, I have come across the phenomena of Clinically Isolated Syndrome (CIS) but I don't know really how that manifests in my case? and with my history and not being on any medication since what it means that I haven't taken treatment from the beta-interferon range, would that have arrested further risks of developing lesions that might be shown on a MRI scan?

I suppose the big question for me is that do I have MS or something other? and how does the CIS factor into my case if it is relevant? Some family members have said that "I should keep on doing what I am doing" but is there anything you suggest I should do to observe and follow. It is difficult for me as I do have a dark shadow that follows me but I am not certain if this is a figment of my imaginaton and I should conrinue to look forwards. I appreciate your time and patience to read through this and I would be most grateful to hear your response.


It is hard for me to provide personal counseling in this forum, since I have no first hand knowledge of your medical history, symptoms, clinical signs or results of examinations. Generally speaking is a clinically isolated syndrome (CIS) an individuals first neurological episode, caused by inflammation or demyelination of tissue in the central nervous system. In a diagnostic context, MRI and cerebro-spinal fluid (CSF) analysis should confirm the clinical findings before treatment options should be considered. The risk of having another episode with neurological symptoms (relapse) in the following three years is approximately 50%, if treatment with e.g. beta-interferon or glatiramer acetate is not initiated. These treatments reduces the risk of a second relapse by approximately 30% and progression on MRI by approximately 50%.
If a person has had two characteristic episodes of neurological symptoms, a diagnosis of MS should be considered since the diagnosis CIS only covers the first episode. 
When and how to treat CIS/MS, is a decision that relies on disease history, neurological deficits and (repeated) MRI, and in that regard you have to consult your MS neurologist.