BACKGROUND: In 2018 multiple sclerosis (MS) care unit (MSCU) recommendations were defined. Nevertheless, the information on MS care, and whether MS centres fulfil the international recommendation is limited. Thus our objectives were to assess whether centres meet the MSCU recommendations and gain a comprehensive overview of MS care in Central-Eastern European countries. METHODS: A self-report questionnaire assessing aspects of the MSCU recommendations, disease-modifying therapy (DMT) and registry use and the patient number was assembled and sent to nine Central-Eastern European countries. Furthermore, one Danish and one German centre were contacted as a reference. RESULTS: In 9/9 countries, MS care was pursued in centres by MS neurologists and MS nurses. In Austria and the Czech Republic, management of MS was conducted under strict regulations displaying a referral centre system, fundamentally similar to but independent of the MSCU criteria. Several centres fulfilled all aspects of the MSCU criteria, while others had similar insufficiencies consisting of a speech therapist, continence, pain and spasticity specialist, neuro-ophthalmologist, and oto-neurologist. In 9/9 countries, DMTs were reimbursed. However, some centres did not provide every available DMT. A national registry was available in 4/9 countries with mandatory registry use only in Austria and the Czech Republic. CONCLUSION: In countries where MSCU recommendations are not fulfilled, a strictly regulated centre system similar to the Austrian and Czech model with a registry-based quality control might ensure appropriate care for people with MS.

1st Department of Neurology Faculty of Medicine Comenius University and University Hospital Bratislava Bratislava Slovakia

Clinic of Neurology University Clinical Centre of Serbia Belgrade Serbia

Danish Multiple Sclerosis Center Copenhagen University Hospital Rigshospitalet Copenhagen Denmark

Department of Neurology Albert Szent Györgyi Faculty of Medicine Albert Szent Györgyi Clinical Centre University of Szeged Szeged Hungary

Department of Neurology Albert Szent Györgyi Faculty of Medicine Albert Szent Györgyi Clinical Centre University of Szeged Szeged Hungary; Department of Radiology Albert Szent Györgyi Faculty of Medicine Albert Szent Györgyi Clinical Centre University of Szeged Szeged Hungary

Department of Neurology Albert Szent Györgyi Faculty of Medicine Albert Szent Györgyi Clinical Centre University of Szeged Szeged Hungary; MTA SZTE Neuroscience Research Group Szeged Hungary

Department of Neurology and Center of Clinical Neuroscience 1st Faculty of Medicine Charles University and General University Hospital Prague Czech Republic

Department of Neurology Institute of Medical Sciences Medical College of Rzeszow University Rzeszow Poland

Department of Neurology Medical University of Lublin Lublin Poland

Department of Neurology Medical University of Vienna Vienna Austria

Department of Neurology School of Medicine Technical University Munich Munich Germany

Department of Neurology School of Medicine Technical University Munich Munich Germany; Munich Cluster for System Neurology Munich Germany

Department of Neurology University Clinical Centre Ljubljana Ljubljana Slovenia

Department of Neurology University Hospital Bucharest Bucharest Romania

Department of Neurology University Hospital Sestre Milosrdnice Zagreb Croatia

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