Consensus guidelines for the diagnosis and treatment of multiple sclerosis

Abstract

The diagnosis of multiple sclerosis (MS) is dependent on the presence of clinical and paraclinical evidence demonstrating dissemination of central nervous system lesions in both space and time, as well as the exclusion of other disorders. Diagnostic criteria were originally promulgated in 1965 by the Schumacher committee and modified subsequently by the Poser committee to include paraclinical evidence. The most recent criteria are the 2010 modifications of the 2001 McDonald criteria, which are focused on making an earlier diagnosis of MS. This article provides guidelines, derived from clinical experience as well as evidence-based medicine, for the diagnosis and management of MS with special emphasis on practices in the Middle East.

Keywords::

• Diagnosis
• Guidelines
• Middle East
• Multiple sclerosis
• Treatment

Transparency

Declaration of funding

Medical writing services from Clinart Contract Research Organization were funded by Novartis Pharmaceutical.

Declaration of financial/other relationships

B. Yamout received honoraria for presentations at meetings and research grants from Biogen, Bayer, Merck Serono, and Novartis. R. Alroughani received honoraria as a speaker fees from Bayer, Novartis, Merck-Serono, Biologix, GSK and served in advisory boards of Bayer, Novartis, Merck-Serono and Biologix. M. Al-Jumah has received educational and research grants from Merck-Serono; as well as educational support and consultancies fees from Biogen, Schering and Novarits. M. Dahdaleh received consultation honorarium from Merck-Serono, Novartis, Biogen, Sherring, Ipsen and Allergan. I. Alsharoqi received educational and research grands from Bayer Schering, and advisory board honoreria from Biogen, Merck Serono, Novartis and Bayer Schering. M. Zakaria received honoraria for participating in TRANSFORMS and EXPAND trials from Novartis; and advisory board honoreria from Serono and Bayer. K. Kallab has received educational support and research grants from Merck-Serono; and educational support from Biogen and Novartis. S. Bohlega received consultation honorarium from Allergan Co., Novartis, Merck Serono and Pfizer. S. Khoury, N. Abouzeid, J. Inshasi, S. Hashe, T. Alsaadi and T. Tawfeek have no financial disclosure to declare. No conflict of interest.

CMRO peer reviewers may have received honoraria for their review work. The peer reviewers on this manuscript have disclosed that they have no relevant financial relationships.

Acknowledgments

The authors thank Zinat Hany PharmD MPH (Clinart CRO) for drafting the manuscript and Ahmed Baly MD (Novartis Pharmaceuticals) for logistics support.