MINIMUM STANDARDS OF DIAGNOSIS The essential criteria of diagnosis of multiple sclerosis are evidences of lesions affecting white matter chiefly, scattered in time and space (that is, repetitive attacks which often give the disease a recurrent regressive and progressive character). Ordinarily, the diagnosis cannot be made unless there is evidence of more than one lesion or unless there are confirmatory findings in the spinal fluid, but characteristic symptoms such as retrobulbar neuritis with central scotoma, symptoms of acute transverse myelitis, diplopia or blurred vision or weakness or numbness of one extremity, if transient, create a presumption for the diagnosis. This presumption is strengthened if one or more of the common physical findings is present, such as palsy of one of the oculomotor nerves, nystagmus, slight ataxia of the arms, absent abdominal reflexes or Babinski or Oppenheim signs. In addition to the foregoing manifestations the following are frequently found: difficulty in