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ISRN Neurol. 2012;2012:792192. doi: 10.5402/2012/792192. Epub 2012 Nov 1.

Predictors of Conversion to Multiple Sclerosis in Patients with Clinical Isolated Syndrome Using the 2010 Revised McDonald Criteria.

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1
Division of Neurology, Amiri Hospital, Qurtoba 73767, Kuwait ; Division of Neurology, Dasman Diabetes Institute, P.O. Box 1180, Dasman 15462, Kuwait.

Abstract

BACKGROUND:

Clinically isolated syndrome (CIS) is the first neurologic episode of multiple sclerosis (MS). Magnetic resonance imaging (MRI) and clinical features are used to predict risk of conversion to MS.

OBJECTIVES:

The aim of this prospective study is to evaluate predictors of conversion of CIS to McDonald MS.

METHOD:

97 patients with CIS have been followed for 2 years. Age of onset, gender, initial clinical presentation, and MRI brain and spine were assessed. The 2010 revised McDonald criteria were applied.

RESULTS:

Fifty-nine patients (60.8%) with CIS converted to McDonald MS after 10.1 + 4.2 months. Thirty-seven (38.1%) of the convertors satisfied the diagnostic criteria based on the radiological parameters, while 21.7% sustained their second clinical events. A multivariate regression analysis revealed that high number of lesions in MRI (P = 0.001) and earlier age of onset (P = 0.043) predicted the conversion of CIS to McDonald MS. Gender (P = 0.5) and initial clinical presentation (optic pathway (P = 0.4), supratentorial (P = 0.91), brain stem/ cerebellum (P = 0.97), and spinal (P = 0.76)) were not statistically significant.

CONCLUSION:

Age of onset and MRI parameters can be used as predictors of CIS conversion to McDonald MS. Application of the 2010 revised McDonald criteria allows an earlier MS diagnosis.

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