In the recently published communication by Langer-Gould et al1 addressing predictors of long-term disability in patients with relapsing-remitting multiple sclerosis (MS), sphincter symptoms and a short interval between the first and second attack were indicated as the most reliable predictors of long-term disability. It was recommended that these factors should be considered before treatment using the currently accepted disease-modifying agents is considered. However, without further specification of the sphincter symptoms, particularly with no objective findings indicating sphincter dysfunction, the actual clinical implication of the recommendation in individual MS patients could prove to have a negative effect on timely treatment.
Frazer ML, Benson JT, Hashemi CAB, Lee H, Rodman KD, Kolar OJ. Spinchter Symptoms as Predictors of Long-term Disability in Multiple Sclerosis. Arch Neurol. 2007;64(9):1359. doi:10.1001/archneur.64.9.1359-a