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09:41
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Failure to develop multiple sclerosis in patients with neurologic symptoms without objective evidence
1Multiple Sclerosis Clinical Research Center, Department of Neurology, Wayne State University School Medicine, Detroit, MI 48201, USA.
Multiple Sclerosis (Houndmills, Basingstoke, England)
|June 25, 2008
Summary
Patients with persistent neurologic symptoms but normal initial tests do not develop multiple sclerosis (MS). Repeated investigations are often unnecessary, especially if follow-up examinations remain normal, avoiding costly procedures.
Area of Science:
- Neurology
- Diagnostic Imaging
- Clinical Medicine
Background:
- Many patients present with symptoms suggestive of multiple sclerosis (MS).
- Initial assessments including neurologic exams, brain MRI, and CSF are often normal.
- Persistent symptoms lead to repeated consultations and investigations.
Purpose of the Study:
- To evaluate the diagnostic utility of repeated evaluations in patients with normal initial findings and persistent neurologic symptoms.
- To determine if patients with initially normal assessments develop MS over time.
Main Methods:
- 143 patients with normal initial neurologic examinations, brain MRI, and CSF were studied.
- 109 patients returned for a second evaluation after a mean interval of 4.4 years.
- Spinal cord imaging and evoked potential studies were performed.
Main Results:
- All initial and follow-up examinations and MRI scans were normal.
- Spinal cord imaging and evoked potential studies showed abnormalities in a small percentage of patients initially.
- No patients met diagnostic criteria for MS at initial presentation or follow-up.
Conclusions:
- Persistent neurologic symptoms without objective evidence do not lead to the development of MS.
- Clinicians can be reassured by normal follow-up examinations.
- Costly serial investigations should be carefully considered, especially with normal follow-up findings.
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