Clinically isolated syndrome, oligoclonal bands and multiple sclerosis

Abstract

AbstractObjectiveClinically isolated syndrome (CIS) is a first demyelinating episode targeting the central nervous system. It can later fulfill the diagnostic criteria for multiple sclerosis (MS) or remain as a single event with no further clinical or paraclinical evidence of disease. Given the difficulty of predicting the long‐term course of the disease at the moment of the first episode, we intended to examine clinical and laboratory features associated with MS conversion, underlining the prognostic value of oligoclonal bands (OCBs) determination.MethodsWe analyzed patients with an episode compatible with CIS (not fulfilling the 2010 McDonald criteria) as the first manifestation of MS (according to the same criteria), observed in our MS clinic (n = 82).ResultsFrom our cohort, 76.8% of patients converted to MS. OCBs were present at baseline in 68.0% of MS patients, but also in 73.7% of stable CIS patients (P = .77). After stratification of the results by treatment, there was also no statistically significant association between the presence of OCBs and conversion to MS. Additionally, positive OCBs did not predict earlier conversion to MS.ConclusionsOur study outlines the high prevalence of positive OCBs in patients with CIS, even in those who, until now, do not fulfill the 2010 diagnostic criteria for MS. This raises questions about the early assumption of MS diagnosis based on OCB status. A very hasty diagnosis could result in chronic treatment initiation and a possibly lifelong stigma in patients who might never develop new lesions or have a second attack.