A self-prepared list of symptoms by patients during an initial visit can help to exclude demyelinating disease, according to a recent study. Patients who present a positive “list sign” also have a high incidence of somatic symptom disorder, it was found. Using chart review, researchers identified 300 consecutive new patients who presented for evaluation to a neurologist at a tertiary multiple sclerosis (MS) referral center. Patients were defined as having demyelinating disease if diagnosed with MS or a related demyelinating condition. Researchers found:

• Of 233 enrolled subjects, 157 were diagnosed with demyelinating disease and 74 did not meet criteria for demyelinating disease.

• 15 (8.4%) subjects had a positive list sign, of which 1 patient had demyelinating disease.

• The 15 subjects described a mean of 12.07 symptoms, and 8 of these patients met Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria for somatic symptom disorder.

• The specificity and positive predictive value of the list sign for non-demyelinating disease were 0.99 and 0.93, respectively.

Citation: Anbarasan D, Campion G, Campion P, Howard J. Clinical utility of the list sign as a predictor of non-demyelinating disorders in a multiple sclerosis (MS) practice. [Published online ahead of print May 2, 2016]. CNS Spectr. doi:10.1017/S1092852916000158.