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MAKING THE DIAGNOSIS OF MULTIPLE SCLEROSIS

Suspected cases of multiple sclerosis (MS) are usually young adults attending the neurology outpatient clinic. The onset of symptoms is rare before puberty or after the age of 60 years; however, being a relatively common neurological disease (1:800 in UK), both situations may be familiar to practising neurologists. MS will usually present with either a history of acute relapse(s) or with progressive neurological impairment#### Key points

The most common presentation of MS is following a relapse. The peak age of the first episode is in the third decade; however, patients often present to the neurologist later with their second or third relapse or less commonly in the secondary progressive phase of illness. This form of MS is twice as common in women as in men.

The most common scenario is a patient of 20–40 years old referred fairly urgently to the outpatient clinic with a subacute onset of neurological disturbance, most commonly sensory symptoms, often resolving by the time they are seen. Because sensory symptoms …