The proportion of patients with clinically isolated syndrome (CIS) reported to convert to clinically definite multiple sclerosis
varied between 30 and 75%. We studied the lifetime probability of
remaining in the "CIS only" condition. The study was based on the
longitudinally followed Gothenburg 1950-1964 incidence cohort (n = 306).
Survival analysis revealed that 17.8% of 236 attack onset patients
remained "CIS only". Patients with afferent (optic and sensory) symptoms
had a better prognosis with approximately 30% of these patients
remaining "CIS only". Patients who had experienced no relapse during the
first 25 years remained "CIS only" for the subsequent 25 years of
follow-up.
Unfortunately NICE has not yet supported the treatment of CISers, but early treatment with highly effective treatment may limit the number converting to MS even more. With MRI evidence the prediction of whether MS will develop is greatly increased. Surely it is about time you have the choice for treatment option.