a clinical diagnosis of multiple sclerosis is only made when neurological events are separated in space and time
therefore one episode of optic neuritis does not mean that a patient fits the clinical criteria for a diagnosis of multiple sclerosis
the risk of developing multiple sclerosis depends on a number of factors such as age and gender (1)
for example, a young man with a first episode of optic neuritis has about a 50% risk of having a further episode of optic neuritis or other demyelinating phenomena in the next 15 years (and therefore satisfying the clinical diagnosis of multiple sclerosis) (1)
an Italian study examined the cumulative risk of developing multiple sclerosis and states (2):
probability of multiple sclerosis was 13% after 2 years, 30% after 4 years, 38% after 6 years, and 49% after 8 and 10 years
multiple sclerosis occurred in 42 (59%) of 71 patients with brain lesions detected with magnetic resonance imaging (MRI)
no patient with normal MRI exam developed the disease
patients with 3 or more MRI-detected lesions presented a shorter first interattack interval and a higher relapse rate compared to subjects with only 1 or 2 lesions
predictive value of CSF examination and of evoked potentials was poor
many neurologists and ophthalmologists will order an MRI scan if a patient has a first episode of optic neuritis - this is for prognostic reasons and will allow a clinician to gain information about the number of active and inactive lesions as well as the clinical picture
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