To tell or not to tell? Revealing the diagnosis in multiple sclerosis

We review briefly (1) the history of patient-physician relationship and its evolution from a physician-centered to patient-centered model; (2) the impact of the McDonald Criteria for Multiple Sclerosis (MS); (3) why it is important to tell patients of their diagnosis; (4) how physicians should disclose the diagnosis to patients; (5) dealing with suspected MS; and (6) prognosis and treatment. For the majority of clinically definite MS patients we advocate disclosure, identify steps for physicians to communicate the diagnosis and propose a framework to follow when revealing a diagnosis of MS.

► We review the evolution of patient-centered medicine and the disclosure of diagnosis in MS. ► Third revision of McDonald diagnostic criteria accelerates confirmation of diagnosis. ► Patient's autonomy and availability of disease modifying treatments encourage early diagnosis. ► Communications techniques were identified to help physicians revealing a diagnosis of MS.