In multiple sclerosis, a definitive clinical diagnosis requires at least how many discrete episodes of exacerbations?

In multiple sclerosis, a definitive clinical diagnosis requires at least how many discrete episodes of exacerbations?

• A. One
• B. Two
• C. Three
• D. Four

Answer: (B)

Two distinct attacks. MS is diagnosed clinically when there is demonstration of demyelination occurring at different times (dissemination in time) and, often, in different CNS areas (dissemination in space). A single episode could be due to many other conditions, but having at least two neurologic events, each lasting typically 24 hours and separated by intervals of recovery, supports a relapsing form of MS and yields a definite clinical diagnosis. MRI can help by showing lesions that demonstrate time and space dissemination, potentially allowing earlier confirmation, but with clinical data alone, two episodes are the minimum.

Two distinct attacks. MS is diagnosed clinically when there is demonstration of demyelination occurring at different times (dissemination in time) and, often, in different CNS areas (dissemination in space). A single episode could be due to many other conditions, but having at least two neurologic events, each lasting typically 24 hours and separated by intervals of recovery, supports a relapsing form of MS and yields a definite clinical diagnosis. MRI can help by showing lesions that demonstrate time and space dissemination, potentially allowing earlier confirmation, but with clinical data alone, two episodes are the minimum.