Contributions
Abstract: EP1373
Type: ePoster
Abstract Category: Clinical aspects of MS - Epidemiology
Background: The NMO spectrum covers different demyelinating conditions as NMO (2006) and the optic-spinal Asian MS (OS-MS) (1996). Both syndromes are characterized by recurrent optic neuritis and transverse myelitis and positivity of the anti-AQP4 antibody. The NMO spectrum syndromes differs from Multiple sclerosis by clinical and laboratorial features.
Objective: To describe characteristics of patients with recurrent optic-spinal phenotype and propose a classification of this subgroup among the demyelinating inflammatory idiopathic diseases of the CNS.
Method: A cohort of patients with recurrent ON and MT were followed from 2000 to 2015 in Hospital da Lagoa (Rio de Janeiro, Brazil). Were selected patients that did not meet criteria for NMO (2006). Data collection included - index events (NO and MT), time between the index events, number of acute events. The spinal cord and visual scale (1999) was applied to analyze the severity of neurological dysfunctions at the index events and at last follow up. Patients with 10 years of disease and EDSS < = 3, were classified as “benign” . IgG index and BOC were analyzed in the CSF. At least one brain MRI and one spinal cord MRI for each patient was analyzed by two neuroradiologists to evaluate the images (blind study). The MS criteria (Polman 2010, Magnims 2016) and NMO criteria were apllied.
Results: Sample of 41 patients, the majority (82.9%) female and white, mean age at onset 29,8 years . Mean time of disease 16.1 year (sd-8.3). Number of events 269 (TM 199, ON 70) . First event : ON in 56%. “At nadir “ the median of visual dysfunction 3 (2 -7) “at recovery “ 0 (0-7) and at last follow 1 (0-7) . Most of the patients had partial TM at index event.: At nadir , sensorial dysfunction 2 (0-3); “at recovery” 0 (0-3) and at last follow up 1 (0-3).Only 9.75% developed secondary progression. Fatigue occurred in 34% ; mean score MFIS scale 31.74 (0-72). The anti-AQP4 was negative. Serial MRI showed radiological criteria for MS in all cases. Only two patients had extensive spinal cord lesions. All patients had optic nerve lesions. BOC positive in the CSF in the majority of cases. One four of the cases never received treatment. DMD were effective in 80% treated cases.
Conclusion: Clinical and laboratorial data indicate that optic-spinal recurrent phenotype is not a NMO spectrum syndrome. Those patients could be classified as subgroup of MS relapsing remitting with benign course.
Disclosure: Nothing to disclose.
Abstract: EP1373
Type: ePoster
Abstract Category: Clinical aspects of MS - Epidemiology
Background: The NMO spectrum covers different demyelinating conditions as NMO (2006) and the optic-spinal Asian MS (OS-MS) (1996). Both syndromes are characterized by recurrent optic neuritis and transverse myelitis and positivity of the anti-AQP4 antibody. The NMO spectrum syndromes differs from Multiple sclerosis by clinical and laboratorial features.
Objective: To describe characteristics of patients with recurrent optic-spinal phenotype and propose a classification of this subgroup among the demyelinating inflammatory idiopathic diseases of the CNS.
Method: A cohort of patients with recurrent ON and MT were followed from 2000 to 2015 in Hospital da Lagoa (Rio de Janeiro, Brazil). Were selected patients that did not meet criteria for NMO (2006). Data collection included - index events (NO and MT), time between the index events, number of acute events. The spinal cord and visual scale (1999) was applied to analyze the severity of neurological dysfunctions at the index events and at last follow up. Patients with 10 years of disease and EDSS < = 3, were classified as “benign” . IgG index and BOC were analyzed in the CSF. At least one brain MRI and one spinal cord MRI for each patient was analyzed by two neuroradiologists to evaluate the images (blind study). The MS criteria (Polman 2010, Magnims 2016) and NMO criteria were apllied.
Results: Sample of 41 patients, the majority (82.9%) female and white, mean age at onset 29,8 years . Mean time of disease 16.1 year (sd-8.3). Number of events 269 (TM 199, ON 70) . First event : ON in 56%. “At nadir “ the median of visual dysfunction 3 (2 -7) “at recovery “ 0 (0-7) and at last follow 1 (0-7) . Most of the patients had partial TM at index event.: At nadir , sensorial dysfunction 2 (0-3); “at recovery” 0 (0-3) and at last follow up 1 (0-3).Only 9.75% developed secondary progression. Fatigue occurred in 34% ; mean score MFIS scale 31.74 (0-72). The anti-AQP4 was negative. Serial MRI showed radiological criteria for MS in all cases. Only two patients had extensive spinal cord lesions. All patients had optic nerve lesions. BOC positive in the CSF in the majority of cases. One four of the cases never received treatment. DMD were effective in 80% treated cases.
Conclusion: Clinical and laboratorial data indicate that optic-spinal recurrent phenotype is not a NMO spectrum syndrome. Those patients could be classified as subgroup of MS relapsing remitting with benign course.
Disclosure: Nothing to disclose.