Should patients with clinically isolated syndrome be started on medication?

Since the 2017 revisions to the McDonald criteria, many patients previously categorized as clinically isolated syndrome (CIS) can be reclassified as relapsing remitting MS with the additions of including symptomatic enhancing lesions and oligoclonal banding on CSF in dissemination in space and time respectively. Patients with CIS that fulfill criteria for dissemination in space likely will benefit from starting a disease modifying therapy to decrease accumulation of disability and in general, th...