A. A history of fluctuations in the clinical course.

B. A physical examination consistent with that of multiple lesionsjinllheiwhite
matter o,f the central nervous system. 
No specific laboratory test is currently available to confirm the diagnosis of MS, however one may find changes in spinal fluid such as poleocytosis, elevated gamma globulins, oligoclonal bands of lgG, and an increase in myelin basic protein. Also changes may be found in visual, auditory and tactile evoked responses. Computed tomography may show various nonspecific findings and nuclear magnetic resonance imaging may show clinically silent demyelinating plaques. There is no therapy currently available to alter the overall course, however ACTH and corticosteroids has been shown to shorten acute exacerbation of the disease. Several MS centers are now utilizing either Cyclophosphamide or Azothioprine to prevent relapses in certain MS patients, however the effectiveness of these drugs and other modalities such as plasma exchange, hyperbaric oxygen, intrathecal interferon injections. teltal lymplioid irradiation, use of transfer factor, and monoclonal antibodies are  under extensive clinical and investigational trials . Special attention has to be paid to different complications of the disease such as weakness, spasticity, tremor, ataxia, pain, bladder bowel and sexual disturbances re1ieving of each calls for appropriate medical and/or surgical interventions.