Multiple sclerosis: When to suspect - Keys to diagnosis

Multiple sclerosis (MS) is characterized by a typical clinical history of neurologic symptoms, separated in time and space, supported by laboratory tests. Key symptoms that signal MS-particularly in young adults-include unilateral vision loss, diplopia that lasts for days or weeks, and hemiparesis that has an insidious or slow onset. A Lhermitte sign can often be elicited, although this finding is not specific for MS. An MRI scan typically shows high-signal lesions on T2-weighted images in the periventricular white matter and often in the cerebellum and brainstem. The presence of oligoclonal bands in the cerebrospinal fluid is a useful but not essential finding to support the diagnosis of MS.