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[Late onset multiple sclerosis].

S Delalande1, J De Seze, D Ferriby

  • 1Service de Neurologie D, Hôpital Roger Salengro, CHRU Lille, 59037 Lille Cedex, France.

Revue Neurologique
|November 27, 2002
PubMed
Summary
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Late-onset multiple sclerosis (MS) presents differently than earlier forms, often with a progressive course and motor symptoms. This form of MS, starting after age 50, indicates a more severe disease evolution.

Area of Science:

  • Neurology
  • Neuroimmunology
  • Clinical Neuroscience

Background:

  • Multiple sclerosis (MS) typically manifests between ages 20-50, with late-onset (after 50) being uncommon and prone to misdiagnosis.
  • Late-onset MS may exhibit distinct clinical presentations and disease trajectories compared to earlier-onset forms.

Purpose of the Study:

  • To investigate the clinical and paraclinical characteristics of multiple sclerosis with onset after 50 years of age.
  • To compare the presentation, course, and prognosis of late-onset MS with earlier-onset MS.

Main Methods:

  • Retrospective analysis of 1,417 MS patients, focusing on those with onset at age 50 or older.
  • Evaluation of demographical data, clinical symptoms, cerebrospinal fluid (CSF) analysis, visual evoked potentials (VEPs), and MRI findings.

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  • Assessment of disease progression using the Expanded Disability Status Scale (EDSS) per year.

    • Main Results:

    • 3.4% of MS patients had onset at age 50+, with 0.45% starting after 59.
    • Late-onset MS predominantly presented in progressive forms (37% primary progressive, 35% secondary progressive); none after 60 had relapsing-remitting MS.
    • Motor symptoms were most common (54%), optic nerve involvement was rare, and the mean progression index was 1, indicating severe evolution. CSF oligoclonal bands were present in 76%, abnormal VEPs in 81%, brain MRI consistent in 71%, and spinal cord MRI abnormal in 60%.

    Conclusions:

    • Late-onset MS differs significantly from earlier-onset MS, characterized by a high frequency of progressive disease courses.
    • Motor function deficits and a poorer prognosis are characteristic of this late-onset MS subgroup.
    • The findings underscore the need for increased awareness and tailored diagnostic and management strategies for late-onset MS.