CIS and MS: What's the Difference?

If your doctor says you have clinically isolated syndrome (CIS) -- a condition with the same symptoms as multiple sclerosis (MS) -- you may have a lot of questions swirling around your mind. The main one might be, "Do I have MS or not?"

It's a reasonable question to ask. Lots of folks get CIS and MS mixed up. There's one main difference between the two conditions. If you have CIS, it's a one-time thing, never to be seen again. You get a single episode and that's it. MS, on the other hand, is a life-long disease.

Still, your doctor will not wait for the distinction between the two diagnoses or a second event to treat you. You will receive the same treatment as an MS patient, even if you have CIS.

What They Have in Common

CIS and multiple sclerosis cause the same kind of damage to the coating on the nerves of your brain and spinal cord. That leads to problems in the normal flow of brain signals in your body.

Because of that, CIS and MS can also have the same symptoms. You might get things like numbness or tingling, problems seeing, trouble with walking and balance, dizziness, and bladder issues. Like an MS flare-up, CIS symptoms last at least 24 hours.

Women are more likely to get both conditions, and they typically show up in adults under age 50.

How They're Different

MS stays with you your whole life and may get worse with time. You'll need regular treatment.

CIS only happens once. But there's one thing to keep in mind. For some folks, it's possible that what you think is CIS turns out to be not just a one-time event, but the opening act of multiple sclerosis. You won't know for sure until your symptoms come back and an MRI starts to show signs of MS.

CIS and MS look different on an MRI. To confirm MS, doctors check for two or more damaged areas in separate and specific areas of your brain or on your spinal cord that happened at different times. With CIS, any areas of the brain can be damaged.

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Will I Get MS if I Now Have CIS?

There's no test that can tell you for sure, but an MRI of your brain and spinal cord gives you some clues.

If you have an MRI that looks like the kind you get with MS, your chances could be high that you'll have multiple sclerosis in the future. If the MRI doesn't look like the ones of MS, your chances are lower.

Your CIS symptoms might also give you some clues. If your senses are affected, like tingling or problems seeing, that could mean a lower chance of getting MS than having issues with walking, balance, and weakness.

Are CIS and MS Treated Differently?

It depends. With MS, you start treatment as soon as you find out you have it.

With CIS, it's less concrete. The symptoms may go away on their own, or you might get a steroid to help improve them. But then you face a question of whether or not to do anything for the long term.

If your risk of getting MS is higher, your doctor may suggest starting the same treatment you'd get for MS. It's called disease-modifying therapy. Some studies show that it can delay when MS sets in and may help prevent serious disabilities.

How Do I Decide to Treat CIS?

It can be a tough decision because you don't know for sure you'll get MS, and the drugs used for treatment have side effects. It helps to find a doctor with a lot of experience with MS. Together, you can weigh the pros and cons.

You can ask questions like:

  • What are the odds I'll get MS?
  • What drugs might work best?
  • What are the risks and side effects?
  • Who can help me decide?

When CIS does turn into MS, how much it affects you varies. In the long run, about a third of people will have only minor, if any, disabilities. But half will have severe MS.

WebMD Medical Reference Reviewed by Neil Lava, MD on October 07, 2018

Sources

SOURCES:

Multiple Sclerosis Trust: "Clinically Isolated Syndrome," "Who Gets MS?" "Treating MS," "Treatments of CIS."

Cedars-Sinai: "Clinically Isolated Syndrome."

The Consortium of Multiple Sclerosis Centers: "CMSC INforMS: Multiple Sclerosis Development: What is Clinically Isolated Syndrome (CIS)?"

The Lancet, Neurology: "Clinically Isolated Syndromes."

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