Hindsight Is 20/20

• Early treatment of MS results in improved clinical outcomes.
• Delays in the definitive diagnosis of MS are common, especially in younger patients, those with primary progressive MS, and those with comorbid disease.
• If a clinical presentation is supported by the presence of oligoclonal bands in the cerebrospinal fluid, a diagnosis of MS can be made on the basis of radiographic evidence of dissemination of disease in space, without evidence of dissemination in time.

Acknowledgments

The authors wish to thank Rabih Geha, MD, and Gurpreet Dhaliwal, MD, for providing feedback on an earlier version of this manuscript.