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Jérôme de Seze, MD, PhD

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In reply

My coauthors and I thank Dr Poser for the interesting comments. We agree with most of these remarks, but we think that they are not applicable to clinical practice. We agree that acute DEM is a different condition compared with MS; however, as Dr Poser says, the 2 diseases are essentially different concerning genetic susceptibility and neuropathological data. If we consider the question to be a clinical point of view, we are not able to use these parameters to distinguished the 2 diseases.

We also agree that extended spinal cord lesions are rare in MS, as stated in the criteria byMcDonald et al. However, in various series, this feature has been found in between 5% and 10% of MS cases^1-2 and is not an exclusion criterion for MS.

Finally, we agree that 16 years is arbitrary, but in France there is a cutoff . . . [Full Text of this Article]

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