Early Clinical Predictors of Disability in Multiple Sclerosis

İrem Fatma Uludağ; Aydın Kaya; Burcu Selbest Demirtaş; Bedile İrem Tiftikçioğlu; Yaşar Zorlu

doi:10.4274/tnd.69320

İrem Fatma Uludağ, Aydın Kaya, Burcu Selbest Demirtaş, Bedile İrem Tiftikçioğlu, Yaşar Zorlu

İzmir Tepecik Training And Research Hospital, Clinic Of Neurology, İstanbul, Turkey

Keywords: Multiple sclerosis, predictive factors, risk factors, prognosis, natural history

Abstract

Objective: The aim of the study was to examine the early predictive clinical factors for long term disability and prognosis in relapsing-remitting multiple sclerosis (RRMS).

Materials and Methods: Using a retrospective design, we studied 112 RRMS patients who were followed for more than 10 years. We investigated the relationship between sex, first attack symptoms, age at the disease onset, number of relapses in the first 5 years and Kurtzke Expanded Disability Status Scale scores (EDSS) at the 5th and 10th years of the disease.

Results: Mean EDSS were 1.69±0.91 at disease onset, 1.84±0.98 and 2.13±1.15 at 5th and 10th years of the disease. First attack symptoms were optic neuritis in 15 (13.4%), brain-stem dysfunction in (13.4%), cerebral hemispheric dysfunction in 51 (45.5%), spinal cord dysfunction in 10 (8.9%), cerebellar dysfunction in 9 (8%) and multisystemic symptoms in 12 (10.7%) patients. Gender, age at disease onset and first attack symptoms were not associated with the increase in EDSS, but EDSS at 5th and 10th years were significantly higher in patients with more frequent relapses in the first 5 years of the disease.

Conclusion: We demonstrated that the high number of relapses in the first 5 years of the disease is a significant risk factor for disease progression. (Turkish Journal of Neurology 2015; 21: 22-6)