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[Optic neuritis, brain stem syndromes and myelitis: rapid conversion to multiple sclerosis]
M Tintoré1, A Rovira, D Hernández
1Unitat de Neuroinmunologia Clínica-Esclerosi Múltiple, Hospital General Universitari Vall d'Hebron, Barcelona. tintore@hg.vhebron.es
Medicina Clinica
|June 22, 1999
Summary
The early risk of multiple sclerosis (MS) is higher in patients with abnormal MRI scans after initial demyelinating events. Abnormal MRI findings significantly increase the conversion rate to MS.
Area of Science:
- Neurology
- Neuroimmunology
- Clinical Neuroscience
Context:
- Isolated demyelinating syndromes are initial clinical presentations that may precede multiple sclerosis (MS).
- Early identification of patients at high risk for MS conversion is crucial for timely intervention.
- Magnetic Resonance Imaging (MRI) is a key tool in the diagnostic workup of demyelinating diseases.
Purpose:
- To determine the early risk of conversion to multiple sclerosis (MS) following isolated demyelinating syndromes.
- To evaluate the predictive value of Magnetic Resonance Imaging (MRI) findings in assessing this early risk.
Summary:
- A prospective study included 98 patients presenting with isolated demyelinating syndromes (optic neuritis, brainstem, spinal cord, or poliregional).
- Patients underwent comprehensive clinical, immunological, electrophysiological, and MRI assessments.
- MRI revealed signal abnormalities in 70% of patients. The overall conversion rate to MS was 18.5%. Crucially, patients with abnormal MRI showed a significantly higher conversion rate (26%) compared to those with normal MRI (4%, p=0.05).
Impact:
- Abnormal MRI findings in the early stages of demyelinating syndromes are a significant predictor of conversion to multiple sclerosis.
- This finding underscores the importance of early MRI in risk stratification and potential therapeutic strategies for patients with demyelinating syndromes.