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For patients with positive MRI at the time of their initial neurologic event, both gadolinium-enhancing lesions and the Barkhof criteria are predictors for development of CDMS over a short interval. However, these results, based on a combined CDMS/MRI outcome, suggest that the majority of these patients are already in the earliest stages of MS, regardless of whether any further MRI criteria are met.

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This new book focusing on clinical care issues ranks as one of the best for clinicians that I have read. Experts in their field of practice cover a wide range of topics. It is written clearly and concisely, and it is well referenced. Furthermore, algorithms make it easy to follow clinical care paths.Family physician A. H. Strelnick has written a preface to the book explaining its usefulness to physicians practicing in primary care settings. Chapter 1 provides information on history, pathogenesis, natural history, and clinical course as well as many other subjects related to diagnosis.Chapter 2 focuses on treatments to alter the course of the disease. The majority of people with MS will need symptom management; therefore, up-to-date management strategies for the major symptoms of the disease are included in this book. In a recent survey by the International MS Society, people with MS ranked psychosocial issues as being of importance in their care. Chapters 9 and 10 of this book address these issues in a knowledgeable way. Chapter 11 deals with important primary care issues and makes it clear that not every symptom is related to MS.Chapters with relevant case studies, community resources, and frequently used medications complete the book.This book became an important reference in recent writings with MS clinic coordinators in Canada. In my opinion, it would make a useful addition to the office of anyone who cares for people with MS.-Reviewed by