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Presenting signs and symptoms in multiple sclerosis.

E A Sanders, E L Bollen, E A van der Velde

    Acta Neurologica Scandinavica
    |March 1, 1986
    PubMed
    Summary

    Multiple sclerosis (MS) patients with initial motor weakness experience greater disability. Conversely, those with sensory symptoms or optic neuritis (ON) show less severe disability, particularly early in the disease course.

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    Area of Science:

    • Neurology
    • Clinical Neuroscience
    • Autoimmune Diseases

    Background:

    • Multiple sclerosis (MS) is a chronic autoimmune disease affecting the central nervous system.
    • The initial presentation of MS symptoms can vary widely among individuals.
    • Understanding the relationship between initial symptoms and long-term disability is crucial for patient management.

    Purpose of the Study:

    • To investigate the association between the presenting signs and symptoms of multiple sclerosis (MS) and subsequent disability outcomes.
    • To compare the long-term disability trajectories based on initial clinical manifestations in MS patients.

    Main Methods:

    • Retrospective analysis of clinical data from 193 patients diagnosed with definite multiple sclerosis (MS).
    • Categorization of patients based on their initial presenting signs and symptoms (e.g., motor weakness, sensory disturbances, optic neuritis).
    • Assessment of disability at various stages throughout the disease course for each patient group.

    Main Results:

    • Patients presenting with initial motor weakness exhibited significantly higher disability levels across all disease stages compared to other groups.
    • Individuals whose initial symptoms were sensory disturbances or paresthesiae demonstrated less severe disability throughout the disease course.
    • Patients with initial optic neuritis (ON) showed a trend towards less disability for the first 20 years, attributed to an asymptomatic period, after which their disability levels became comparable to other groups.

    Conclusions:

    • The initial clinical presentation in multiple sclerosis (MS) is a significant predictor of long-term disability.
    • Motor weakness as the first symptom is associated with a more severe disease course.
    • Early sensory symptoms or optic neuritis may indicate a less disabling form of MS, especially in the initial two decades.

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