ABSTRACT
Radiologically isolated syndrome (RIS) was defined for the first time in 2009 with an attempt to establish objective criteria of diagnosis for the patients, who underwent brain MRI scanning for a reason other than multiple sclerosis (MS), but were found to have white matter lesions in their central nervous systems (CNS) similar to those present in patients with diagnosed MS. RIS has been defined as separate entity with the presence of MRI findings strongly suggestive of MS in a patient with no neurological manifestations or other clear-cut explanation. Healthy patients may have an initial MRI procedure performed due to different reasons other than suspicion of MS, mainly because of headaches. However, a clinical examination does not reveal any signs of focal neurological deficits and there are no evidence for the focal damage in the CNS in these patients as well. Although RIS is not the first stage of multiple sclerosis in every patient, 30 up to even 45% of individuals diagnosed with this condition will present clinical symptoms in the future, within median time from 2.3 to 5.4 years depending on various researches. Most authors agree, that about 1/3 of patients with RIS will convert to clinically definite MS within 5 years of follow-up. There are some significant predictors of conversion, among others – presence of lesions in cervical and thoracic spinal cord. Moreover, patients with RIS, although asymptomatic in the meaning of classic clinical presentation of MS, are proved to experience early axonal loss, brain atrophy, increased anxiety and depression and subclinical inflammatory disease, as well as some signs of cognitive impairment. In this article we aim to make a review of the newest papers published in 2017 and 2018 concerning Radiologically Isolated Syndrome.
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