Abstract： Objective To investigate the first pathogenetie feature and the reason of misdiagnosis about the multiple sclerosis(MS). Methods To review and analyze 62 eases with the first pathogenetic medical record of MS. Results The most frequent clinical manifestation pf the first pathogenetie MS are the limbs paraesthesia(18 eases, 29.0%) ,dyskinesia(16 cases,25.8%) and visual disorder(11 cases, 17.7%), and the other clinical manifestation are the ataxia, epileptic seizure ,dyasarthria, dysuria, itch of skin, mental anomaly, vertigo and so on. The total of misdi-agnosis is 24 cases (38.7 %). Conclusion Except the main clinical manifestation, there are diversity, complexity forfirst pathogenetic MS,what's more the misdiagnosis rate is very high.