Multiple sclerosis: Approaches to early diagnosis and new treatment options

PURPOSE: To review the signs and symptoms of multiple sclerosis (MS) as well as existing and emerging therapies. EPIDEMIOLOGY: MS is the most common nontraumatic cause of disability in young adults, generally striking between the ages of 15 and 50 years. Women are twice as likely as men to develop MS. Estimates place the prevalence at 250 000 to 350 000 people in the United States alone, but the true prevalence is believed to be higher. Epidemiologic data also point to people of Northern European ancestry as being particularly vulnerable, although recent trends suggest that racial blending and other factors have resulted in more diffuse manifestations across populations. REVIEW SUMMARY: This review summarizes the clinical signs and symptoms of MS as well as new diagnostic criteria. Current treatments and areas fertile for future research also are discussed. TYPE OF AVAILABLE EVIDENCE: Nationally recognized guidelines for disease diagnosis, review articles, randomized clinical control trials, expert opinion. GRADE OF AVAILABLE EVIDENCE: Good. CONCLUSION: Primary care physicians play a particularly important role in the early recognition of clinical signs of MS and are uniquely positioned to ensure early treatment.