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July 2000

To Treat, or Not to Treat: The Therapeutic Dilemma of Idiopathic Monosymptomatic Demyelinating Syndromes

Arch Neurol. 2000;57(7):930-932. doi:10.1001/archneur.57.7.930

IDENTIFYING EFFECTIVE treatments that alter the disease process in multiple sclerosis (MS) has been a 150-year odyssey involving all corners of the earth. On the subject of treatment for MS, Charcot1 in 1877 stated that ". . . the time has not yet come when such a subject can be seriously considered." Until very recently, this still held true.

Recognition that the disease process in MS was related to perturbations in immune system activity led to the assessment of anti-inflammatory and immunosuppressant therapeutic strategies. The elucidation of networks that regulate immune system activity has yielded new immunotherapeutic approaches. Furthermore, details of the disease process in MS have been identified that will facilitate the design of targeted therapies with greater specificity and effectiveness.

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