Differential Diagnosis, Clinical Features, and Prognosis of Multiple Sclerosis

The diagnosis and prognosis of multiple sclerosis (MS) has changed dramatically over the years from the first descriptions from St. Lidwina of Schiedam (1380– 1433) and Augustus D’Este (grandson of George III) between 1822 and 1848 to the pathological descriptions of Cruveilhier (1829–1842) and Carswell (1838). Serious study and synthesis of clinical and pathological human MS began with the work of Jean Martin Charcot at the Salpetriere in Paris in the last three decades of the 19th century. Recently, there has been a trend to classify MS as an immune-mediated demyelinating disease of the central nervous system (CNS). This classification is useful as a diagnostic tool, as demonstrated by Schumacher (1962) and Poser (1983). The new diagnostic criteria (1), which is discussed in detail in the remainder of this chapter, has changed the diagnosis, prognosis, and treatment of MS.