Discussion and Concluding Remarks

ARS Polling How familiar are you now with how MS is diagnosed? Very Somewhat Not at all

ARS Polling How familiar are you now with the revised McDonald criteria in assessing MS patients? Very somewhat Not at all

ARS Polling Very Somewhat Not at all How familiar are you now with the CMSC standardized protocol for performing MRIs? Very Somewhat Not at all

ARS Polling How often do you now plan to order MRIs for patients you suspect have MS? Always Very often Sometimes Not very often Never

ARS Polling How often do you now plan to refer patients for further MS assessment/treatment at the time of a first clinical episode likely to be MS? Always Very often Sometimes Not very often Never

ARS Polling Always Very often Sometimes Not very often Never How often do you now plan to provide patients with strategies for managing common side effects of first-line MS therapies? Always Very often Sometimes Not very often Never

ARS Polling How often do you now plan to ask patients nonjudgmentally about adherence (eg, “How many injections have you missed in the past 2 months?”)? Always Very often Sometimes Not very often Never

ARS Polling How often do you now plan to recommend pharmacologic and nonpharmacologic therapies to manage bothersome MS symptoms (eg, fatigue, bladder dysfunction, spasticity)? Always Very often Sometimes Not very often Never

Final Conclusions Pathogenesis of MS involves interactions between genetic and environmental factors; results in inflammation and axonal loss Diagnosis is based on clinical and radiologic factors High-risk CIS should be treated the same as CDMS MS therapies can reduce relapse rates and disability progression After starting therapy, monitor response, tolerability, and adherence Several new therapies are being developed, some oral There are many treatments for common MS symptoms that can improve QOL—ask patients about their symptoms Various resources are available to help (eg, NMSS, MSAA, Multiple Sclerosis Resource Network–Northwest Region) Consider referral to MS Centers for complicated cases