The diagnosis of an attack in multiple sclerosis should be supported by the presence of some objective evidence.
Patient selection: The patient has a sign or symptom indicative of an anatomic region in the CNS.
Objective evidence involves an abnormality at that region identified on:
(1) the neurological examination
(2) imaging (MRI or optical coherence tomography), or
(3) neurophysiological testing (visual evoked potentials)
Caution should be exercised in accepting symptoms accompanied only by patient-reported subjective alteration as evidence of a current or previous attack.
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