Several important developments in the field of MS research have served to underscore the need for early diagnosis, specifically the disease-modifying therapies (DMTs) along with a more thorough understanding of what happens between relapses.

Through the use of MRI, researchers now understand that the disease may actually be active during periods of apparent remission. In other words, during a remission, when your symptoms are silent or have improved — when you think the disease is stable — the disease process may still be active in your CNS.

Researchers are studying what are called clinically silent lesions — lesions that don't cause obvious symptoms but are nonetheless actively damaging your CNS. In fact, researchers agree that many patients have silent lesions years before obvious symptoms begin to surface. As a result, damage to the nervous system can be much more extensive than a health professional might have guessed by just looking at a patient's symptoms or neurological examination. In fact, this unchecked disease activity might surface one day as clinical symptoms and eventually disability. What causes silent lesions? Researchers theorize that some of the lesions that occur in the CNS are located in areas that do not cause obvious symptoms, such as optic neuritis or left-handed weakness.

It wasn't long ago that early diagnosis had little to offer the person with MS, but experts now agree that DMTs (including Avonex, Betaseron, Copaxone, Novantrone, Rebif, and Tysabri) hold the best chance of keeping the disease at bay when started early. Neurologists and researchers alike have been debating the benefits of early treatment in people who have had only one attack and do not fit the criteria for definite MS diagnosis. This is referred to as a clinically isolated syndrome (CIS), which in essence is like a first attack of MS — a single clinical event that points to demylenation in the brain or spinal cord. You may have had, for example, just one single episode of optic neuritis without any other symptoms present. This would constitute a clinically isolated syndrome.

People who have experienced a CIS and have an abnormal MRI are at significant risk for developing MS. Studies that involved the drugs Avonex, Betaseron, and Rebif found that each drug delayed the onset of full MS in people who had experienced their first attack. Treating CIS should be discussed in detail with one's physician. It's a good idea to be well informed so that you can make the decision that is best for you.