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This model intends to provide easy to learn information related to the Clinical Isolated Syndrome, including optic neuritis, brain stem syndrome and spinal cord syndrome), which are frequently the first clinical presentation of multiple sclerosis.

In particular, the model enables the user, either clinician or patient, to foresee what is expected, in a population basis, for the outcome at 20 years of disease progression, based on the MRI abnormalities at the initial clinical event.

This is an experimental research model not to be used yet in the clinical practice.


The model was drawn upon the data published on the following paper:

L. K. Fisniku, P. A. Brex, D. R. Altmann, K. A. Miszkiel, C. E. Benton, R. Lanyon, A. J. Thompson1, and D. H. Miller. Disability and T2 MRI lesions: a 20 -year follow-upof patients with relapse onset of multiple sclerosis. Brain (2008), 131, 808-817.


The first thing is to press the SETUP button. Then, one must select the number of MRI lesions at baseline and to press the GO button. The model will show the probability of conversion to clinical definite multiple sclerosis - CDMS (define by a second clinical event) as well as the median time for that conversion occur, together with the probabilities of disability, expressed in terms of EDSS <=3, >3 and >6, after 20 years of disease evolution of the patients that have converted to CDMS.

In addition, the projections can be refined later on, if data on T2 lesion volume is available at baseline and at year 5. It is only necessary to select the respective volumes and to press the CALCULATE button.


Mário Veloso, consultant neurologist