Contributions
Abstract: P658
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Background: From the introduction of the 2010 McDonald criteria of multiple sclerosis (MS), new evidences regarding the application of MRI has been described. In 2016 MAGNIMS network proposed new criteria and in 2017 new revised McDonald criteria has been proposed. Neither of them have been applied in secondary hospitals.
Aims: To compare McDonald 2010 criteria, MAGNIMS 2016 criteria and McDonald 2017 after the clinically isolated syndrome (CIS) in patients with a diagnosis of MS in a secondary hospital.
Methods: Retrospective evaluation of all patients diagnosed with relapsing-remitting MS (RRMS) from 2009 to 2018 in a secondary hospital. Comparison of clinical notes and magnetic resonance imaging (MRI) to determine the fulfillment of McDonald 2010, MAGNIMS 2016 and McDonald 2017 criteria and the time and number of MRI required.
Results: 73 patients were diagnosed of RRMS. Female to male ratio of 2.33 and the mean age of onset 34 years. 89% has positive cerebrospinal fluid specific oligoclonal bands (CSF-OCBs). The most frequent CIS were: sensory symptoms (40%), optic neuritis (25%) and brainstem syndrome (21%). Using the McDonald 2010 criteria, 8 patients (11%) did not fulfill MRI criteria, 10 patients (14%) MAGNIMS 2016 and 1 patient McDonald 2017. The diagnosis was made performing only one MRI in 32% of patients using McDonald 2010 criteria, 33% MAGNIMS 2016 and 90% using McDonald 2017 (47% of these patients had dissemination in space demonstrated by MRI and CSF-OCBs but not dissemination in time). Using the different criteria, the number of MRIs needed was: McDonald 2010: 1 MRI in 32%, 2: 36%, 3: 18%; MAGNIMS 2016: 1: 33%, 2: 33%, 3: 16%; 90% of patients needed only 1 MRI for diagnosis of MS with McDonald 2017 criteria. The time between CIS and the diagnosis of MS was also bigger using McDonald 2010 and MAGNIMS 2016 criteria than McDonald 2017; only 37% of patients were diagnosed during the first 6 months after the onset of the CIS using McDonald 2010, 38% with MAGNIMS 2016 and 83% with McDonald 2017.
Conclusions: The new 2017 propose revisions to the McDonald diagnostic criteria for MS seems to allow earlier diagnosed. Even in a secondary hospital using these new criteria, most patients presenting with a CIS would need only 1 MRI to fulfill the criteria. The presence of CSF-OCBs in patients with CIS considered for the diagnosis, made it easier and faster. No big differences have been found between McDonald 2010 and MAGNIMS 2016 in our study.
Disclosure: J. Diaz Diaz: nothing to disclose. JJ. Jover Sanchez: nothing to disclose. IC. Ferreiro Argüelles: nothing to disclose. E. Rodriguez Garcia: nothing to disclose
Abstract: P658
Type: Poster Sessions
Abstract Category: Clinical aspects of MS - Diagnosis and differential diagnosis
Background: From the introduction of the 2010 McDonald criteria of multiple sclerosis (MS), new evidences regarding the application of MRI has been described. In 2016 MAGNIMS network proposed new criteria and in 2017 new revised McDonald criteria has been proposed. Neither of them have been applied in secondary hospitals.
Aims: To compare McDonald 2010 criteria, MAGNIMS 2016 criteria and McDonald 2017 after the clinically isolated syndrome (CIS) in patients with a diagnosis of MS in a secondary hospital.
Methods: Retrospective evaluation of all patients diagnosed with relapsing-remitting MS (RRMS) from 2009 to 2018 in a secondary hospital. Comparison of clinical notes and magnetic resonance imaging (MRI) to determine the fulfillment of McDonald 2010, MAGNIMS 2016 and McDonald 2017 criteria and the time and number of MRI required.
Results: 73 patients were diagnosed of RRMS. Female to male ratio of 2.33 and the mean age of onset 34 years. 89% has positive cerebrospinal fluid specific oligoclonal bands (CSF-OCBs). The most frequent CIS were: sensory symptoms (40%), optic neuritis (25%) and brainstem syndrome (21%). Using the McDonald 2010 criteria, 8 patients (11%) did not fulfill MRI criteria, 10 patients (14%) MAGNIMS 2016 and 1 patient McDonald 2017. The diagnosis was made performing only one MRI in 32% of patients using McDonald 2010 criteria, 33% MAGNIMS 2016 and 90% using McDonald 2017 (47% of these patients had dissemination in space demonstrated by MRI and CSF-OCBs but not dissemination in time). Using the different criteria, the number of MRIs needed was: McDonald 2010: 1 MRI in 32%, 2: 36%, 3: 18%; MAGNIMS 2016: 1: 33%, 2: 33%, 3: 16%; 90% of patients needed only 1 MRI for diagnosis of MS with McDonald 2017 criteria. The time between CIS and the diagnosis of MS was also bigger using McDonald 2010 and MAGNIMS 2016 criteria than McDonald 2017; only 37% of patients were diagnosed during the first 6 months after the onset of the CIS using McDonald 2010, 38% with MAGNIMS 2016 and 83% with McDonald 2017.
Conclusions: The new 2017 propose revisions to the McDonald diagnostic criteria for MS seems to allow earlier diagnosed. Even in a secondary hospital using these new criteria, most patients presenting with a CIS would need only 1 MRI to fulfill the criteria. The presence of CSF-OCBs in patients with CIS considered for the diagnosis, made it easier and faster. No big differences have been found between McDonald 2010 and MAGNIMS 2016 in our study.
Disclosure: J. Diaz Diaz: nothing to disclose. JJ. Jover Sanchez: nothing to disclose. IC. Ferreiro Argüelles: nothing to disclose. E. Rodriguez Garcia: nothing to disclose