Treating clinically isolated syndrome: the long game.

One of the fundamental tasks in the inflammatory arena is to prevent the conversion of a Whilst there are many theories, over many years, the exact cause of multiple sclerosis (MS) is unknown. Despite having to peer through this mist, unparalled advances have been made over the last 2 decades with transformative treatments, usually with an anti-inflammatory basis. Yet if treatment could begin at the earliest of manifestations, then logic would dictate a better outcome. The clinically isolated syndrome (CIS) is this first point in the graph. Studies stretching over 20 years have given indicative conversion rates to clinically definite MS (CDMS) of the order of 60%, but ranging from 20-80% depending on the original MRI appearance.1