Clinically isolated syndrome

A clinically isolated syndrome (CIS, Eng. Clinically isolated syndrome , shortly CIS) is a neurological disorder relating to the demyelinating one or (more rarely) several places in damage to the central nervous system can be traced back (CNS).

The monophasic symptoms appear in the sense of a flare- up: the symptoms must develop acutely or subacutely (i.e. within hours to days) and persist for at least 24 hours. They can regress or survive. There should be no infection or fever .

Common manifestations are unilateral inflammation of the optic nerve (optic neuritis) and deficits (such as paralysis , sensory disorders or coordination disorders ) as a result of damage to the cerebrum , brain stem , spinal cord and cerebellum . In addition, a large number of less typical complaints are possible.

If the diagnostic criteria for multiple sclerosis are met, the clinically isolated syndrome is the first episode of multiple sclerosis. For the diagnosis to be made, the criteria of local and temporal dissemination must be met. Depending on the constellation of findings from further diagnostics ( magnetic resonance tomography , liquor diagnostics ), this can already be the case with the clinically isolated syndrome. In around 85% of all patients with multiple sclerosis , the disease manifests itself for the first time in the form of a clinically isolated syndrome. Risk factors for the transition to multiple sclerosis are the detection of oligoclonal bands in the cerebrospinal fluid and the detection of clinically silent MS-typical lesions on magnetic resonance imaging (MRI) of the head.

A clinically isolated syndrome often resolves without therapy. For the treatment of a severe, clinically isolated syndrome, high-dose methylprednisolone can be given for several days. Glatiramer acetate as well as interferon beta-1a and interferon beta-1b are approved for course-modifying therapy if there is a high risk of developing multiple sclerosis.

See also

• Radiologically isolated syndrome (RIS)

literature

• David H. Miller, Declan T. Chard, Olga Ciccarelli: Clinically isolated syndromes. In: The Lancet Neurology . 11, 2012, pp. 157-169, doi : 10.1016 / S1474-4422 (11) 70274-5 .

Individual evidence

1. ↑ ^{a b c} Alan J. Thompson, Brenda L. Banwell et al. a .: Diagnosis of multiple sclerosis: 2017 revisions of the McDonald criteria. In: The Lancet Neurology . 17, 2018, p. 162, doi : 10.1016 / S1474-4422 (17) 30470-2 .
2. ↑ O. Aktas, MP Wattjes, M. Stangel, H.-P. Hartung: Diagnosis of Multiple Sclerosis: Revision of the McDonald Criteria 2017. In: Der Nervenarzt . 89, 2018, pp. 1344-1354, PMID 29876600 , doi : 10.1007 / s00115-018-0550-0 . (Contains examples of diagnosis)
3. ↑ ^{a b c} David H. Miller, Declan T. Chard, Olga Ciccarelli: Clinically isolated syndromes. In: The Lancet Neurology. 11, 2012, pp. 157-169, doi : 10.1016 / S1474-4422 (11) 70274-5 .
4. ↑ Competence Network Multiple Sclerosis: Quality Manual MS / NMOSD . Edition 2019.

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