LABORATORY DIAGNOSIS OF MULTIPLE-SCLEROSIS - IMMUNOLOGICAL AND BIOCHEMICAL ASPECTS

The diagnosis of multiple sclerosis must remain a clinical one, supported but not supplanted by the increasingly popular magnetic resonance imaging, which is non-specific and is frequently overinterpreted by radiologists lacking appropriate clinical information. Reliance on the multiple sclerosis as the principal if not exclusive basis for the diagnosis leads to error in as many as one third of cases. This assumes a great deal of importance considering that such non-multiple sclerosis patients may be counted in epidemiological surveys and included in therapeutic trials for disease-modifying drugs. Not surprisingly, attempts to develop reliable criteria diagnostic possibilities require more and more tests, often yielding confusing if not misleading abnormalities, not to mention the cost and discomfort to the patient. As it was many years ago, there is no substitute for a detailed history and a thorough neurological examination by an experienced neurologist.