Abstract
Introduction. Multiple Sclerosis (MS) is a disease with devastating consequences on patients, diagnostic confirmation based on clinical and paraclinical criteria, unified in the McDonald 2010 criteria is not easy.
Objective. To improve the quality of the diagnostic and therapeutic process of MS patients determining compliance of clinical and imaging criteria of MS and compare the initial diagnosis with the end results of 52 patients diagnosed with MS who were evaluated between April 2010 and November 2011 at the outpatient clinic "Neurologos de Occidente" in Cali-Colombia.
Materials and Methods. Retrospective observational study with N=52 patients, with presumptive or confirmed MS diagnosis ( CIE-10:G35X). Patients and medical records were reviewed to determine whether they meet criteria of the revised McDonald 2010 criteria, establishing dichotomous variables according to the clinical and radiological assessment and definitive diagnosis.
Results: The ratio by gender was 1.5:1 in favour of women. The age ranged from 18 to 69 years, with an average of 44,7 years (DS ± 12,193) with a prevalent age group between 41-69 years. Out of 52 patients 41 (78,8%) showed symptoms suggestive of MS, but when reviewing and applying the radiological criteria it was found that only 30/52 (57%) met them and from the total number of patients in accordance with the McDonald-2010 criteria, 33/52 were validated. (63.4%)
Conclusion. This study showed that and intermediate proportion of patients fulfill Mc Donald 2010 criteria for multiple sclerosis.
References
ANDERSON DW, ELLENBERG JH, LEVEN-THAL CM, REINGOLD SC, RODRIGUEZ M, SIL BERBERG DH. Revised estimate of the prevalence of multiple sclerosis in the United States. Ann Neurol. 1992; 31:333-6.
KOUTSOURAKI E, COSTA V, BALOYANNIS S. Epidemiology of multiple sclerosis in Europe: A Review. Int Rev Psychiatry. 2010; 22:2-13.
WEINSHENKER BG, BASS B, RICE GP, NOSE-WORTHY J, CARRIERE W, BASKERVILLE J, EBERS GC. ET AL. The natural history of multiple sclerosis: a geographically based study. I. Clinical course and disability. Brain. 1989; 112:133-46.
RUNMARKER B, ANDERSEN O. Prognostic factors in a multiple sclerosis incidence cohort with twenty-five years of follow-up. Brain. 1993; 116:117-34.
KAPPOS L, FREEDMAN MS, POLMAN CH, EDAN G, HARTUNG HP, MILLER DH, ET AL. Effect of early versus delayed interferon beta-1b treatment on disability after a first clinical event suggestive of multiple sclerosis: a 3-year follow-up analysis of the BENEFIT study. Lancet. 2007; 370:389-97.
MILLER D, BARKHOF F, MONTALBAN X, THOMPSON A, FILIPPI M. Clinically isolated syndromes suggestive of multiple sclerosis, part I: natural history, pathogenesis, diagnosis, and prognosis. Lancet Neurol. 2005; 4:281-88.
POSER C, BRINAR V. The Accuracy of Prevalence Rates of Multiple Sclerosis: A Critical Review. Neuroepidemiology. 2007; 29:150-5.
POLMAN CH, REINGOLD SC, BANWELL B, CLANET M, COHEN JA, FILIPPI M, ET AL. Diagnostic Criteria for Multiple Sclerosis: 2010 Revisions to the McDonald Criteria. Ann Neurol. 2011; 69:292-302.
NOSEWORTHY JH, LuCCHINETTI C, RODRIGUEZ M, WEINSHENKER BG. Multiple sclerosis. N Engl J Med. 2000; 343:938-52.
WHETTEN-GOLDSTEIN K, SLOAN FA, GOLDSTEIN LB, KULAS ED. A comprehensive assessment of the cost of multiple sclerosis in the United States. Multiple Sclerosis. 1998; 4:419-42.
POSER CM, PATY DW, SCHEINBERG L, MCDONALD WI, DAVIS FA, EBERS GC, ET AL. New diagnostic criteria for multiple sclerosis. Ann Neurol 1983; 13:227-31.
MCDONALD WI, COMPSTON A, EDAN G, GOODKIN D, HARTUNG HP, LUBLIN FD, ET AL. Recommended diagnostic criteria for multiple sclerosis: guidelines from the international panel on the diagnosis of multiple sclerosis. Ann Neurol. 2001; 50:121-7.
SWANTON JK, FERNANDO K, DALTON CM, MISZKIEL KA, THOMPSON AJ, PLANT GT, ET AL. Modification of MRI criteria for multiple sclerosis in patients with clinically isolated syndromes. J Neurol Neurosurg Psychiatry. 2006; 77:830-3.
RUDICK, RA, MILLER A E. Multiple sclerosis or multiple possibilities: The continuing problem of misdiagnosis. Neurology. 2012; 78:1904-6.
SOLOMON AJ, KLEIN E P, BOURDETTE D. Undiagnosing multiple sclerosis: The challenge of misdiagnosis in MS. Neurology. 2012; 78:1986-91.
BOISSY AR, FORD PJ. A touch of MS: Therapeutic mislabeling. Neurology. 2012; 78:1981-5.
SÁNCHEZ JL, AGUIRRE C, ARCOS-BURGOS OM, JIMÉNEZ I, JIMÉNEZ M, LEÓN F, ET AL. Prevalencia de la esclerosis múltiple en Colombia. Rev Neurol. 2000; 31:1101-3.
TORO J, SARMIENTO OL, DíAZ DEL CASTILLO A, SATIZÁBAL CL, RAMÍREZ JD, MONTENEGRO AC, GÓNGORA MC, ET AL. Prevalence of multiple sclerosis in Bogotá, Colombia. Neuroepidemiology. 2007; 28:33-38.
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.