Clinical evaluation and follow-up in multiple sclerosis

The clinical assessment of the evolution of Multiple Sclerosis (MS) is base d on international criteria. For the definition of relapse and progression, the so-called Schumacher criteria (1965) may be chosen. For the definition of clinical subtypes (relapsing-remitting, secondary progressive, primary progressive, and progressive-relapsing), the criteria issued from a survey conducted by the group of Lublin (1996) are mandatory. One may be cautious to apply such research-driven sets of criteria to clinical practice. Many s cales have been elaborated for the evaluation of the handicap caused by MS (i.e. neurological deficit, impairment, and "handicap"). None is perfect, b ut the Expanded Disability Status Scale (EDSS, Kurtzke, 1983) is widely use d. Recent developement in the elaboration process of scales ("scalology") m ay soon lead to the validation of new composite outcome measures.