Aim: To provide an insight into the current issues in the diagnosis and management of multiple sclerosis (MS).
Methods: A literature-based review was undertaken to determine diagnostic criteria, differential diagnosis, and the use of disease-modifying medication and symptomatic treatments for MS. The main source of references was Medline via PubMed but standard major reference works on MS were also used.
Results: The prevalence of MS may be increasing, especially in women, thereby increasing the need for resources for diagnosis and clinical management of the condition. Clinical diagnosis of MS has changed little since the descriptions of Charcot. However, new diagnostic techniques ranging from neurophysiology and spinal fluid analysis to increasingly sophisticated magnetic resonance imaging have allowed the condition to be diagnosed earlier and with more confidence. New insights in immunology and neuropathology allow differential diagnoses to be excluded and continue to lead to different approaches to managing the condition. New disease-modifying drugs are being used, with the realistic hope of altering the progression of disability. Equally important are new techniques and medications aimed at symptom management, ranging from multidisciplinary team working to drug treatment of pain, fatigue, spasticity, continence and nystagmus.
Conclusions: There is continuing improvement in many aspects of the care of people with MS. Insights from epidemiology, genetics, pathology and clinical trials have all contributed to this.