Some neurologists, many in academic circles, have a perception that MS is predictably associated with dis-ability. Before the advent of new testing procedures, particularly MRI of the brain and spinal cord, many patients were not diagnosed during life. Without proven treatments, there was little incentive to do so in those without disability.
The training of many more neurologists in recent years has led to greater availability of neurologic consultation; therefore, a larger pro-portion of previously undiagnosed patients are now correctly recognized as having MS. Thus, in the past, those who had more evidence of disability than the majority were correctly diagnosed; those who were minimally affected were not. Now that a variety of treatments are available, the importance of early diagnosis and treatment is accepted, and we are seeing a larger number of patients correctly diagnosed as having MS.
In my experience, general physicians previously gave about two thirds of the women who were diagnosed with MS an initial “psychiatric” label. Now, with the advantages of increasing numbers of physicians (neurologists) trained to recognize MS and the general availability of MRI equipment, many more people are recognized as having this disorder. In Europe, where large numbers of patients have been cared for in specialty centers, it is now evident that the majority of these people with MS are not disabled.