Related Experiment Video
Updated: Mar 9, 2026
Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Published on: July 19, 2019
Causes of death in critically ill multiple sclerosis patients
A Karamyan1, H Brandtner2, S Grinzinger1
1Department of Neurology, Christian Doppler Medical Center, Paracelsus Medical University, Salzburg, Austria.
Background:
Patients with multiple sclerosis (MS) experience higher mortality rates as compared to the general population. While the risk of intensive care unit (ICU) admission is also reported to be higher, little is known about causes of death CoD in critically ill MS patients.
Aim:
To study the causes of death (CoD) in the series of critically ill patients with MS verified by autopsy.
Methods:
We reviewed hospital electronic charts of MS patients treated at the neurological ICU of a tertiary care hospital between 2000 and 2015. We compared clinical and pathological CoD for those who were autopsied.
Results:
Overall, 10 patients were identified (seven female; median age at death 65 years, range 27-80), and six of them were autopsied. The median MS duration prior to ICU admission was 27.5 years (range 1-50), and the median EDSS score at the time of ICU admission was 9 (range 5-9.5). The median length of ICU stay was 3 days (range 2-213). All the individuals in our series had experienced respiratory insufficiency during their ICU stay. The autopsy examination of brain tissue did not reveal evidences of MS lesions in one patient. In another patient, Lewy bodies were found on brain immunohistochemistry.
Conclusion:
Mortality in critically ill MS patients is largely driven by respiratory complications. Sporadic disparities between clinical and pathological findings can be expected.
Insights
Mortality in critically ill multiple sclerosis (MS) patients is primarily due to respiratory complications. Autopsies revealed potential discrepancies between clinical and pathological findings in some cases.
Area of Science:
- Neurology
- Critical Care Medicine
- Pathology
Background:
- Patients with multiple sclerosis (MS) have increased mortality rates compared to the general population.
- Critically ill MS patients face a higher risk of intensive care unit (ICU) admission, but causes of death are not well understood.
Purpose of the Study:
- To investigate the causes of death (CoD) in critically ill multiple sclerosis (MS) patients using autopsy findings.
Main Methods:
- Retrospective review of electronic health records for MS patients admitted to a neurological ICU (2000-2015).
- Comparison of clinical and pathological causes of death in autopsied patients.
Main Results:
- Ten MS patients were identified; six underwent autopsy.
- All patients experienced respiratory insufficiency during ICU stay.
- Autopsy revealed no MS lesions in one brain sample and Lewy bodies in another.
Conclusions:
- Respiratory complications are the main drivers of mortality in critically ill MS patients.
- Discrepancies between clinical and pathological findings may occur.
More Related Videos
Related Concept Videos
01:30Acute Respiratory Failure-III
01:20Myasthenia Gravis: Overview and Treatment
These antibodies interfere with the function of the nicotinic receptors in three ways: by binding to the receptor and disrupting acetylcholine binding; by causing cross-linking of receptors which...