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- Title
The prognostic value of brain MRI in clinically isolated syndromes of the CNS. A 10-year follow-up.
- Authors
O'Riordan, JI; Thompson, AJ; Kingsley, DPE; MacManus, DG; Kendall, BE; Rudge, P; McDonald, WI; Miller, DH
- Abstract
A definitive diagnosis of multiple sclerosis cannot be made at presentation on patients with a clinically isolated syndrome of the optic nerve, spinal cord or brainstem suggestive of demyelination, as dissemination in time is not established. To determine the long-term risk of abnormalities on brain MRI for the development of multiple sclerosis and disability we performed a 10-year follow-up on 81 such patients who had T2-weighted brain MRI at presentation. Initial brain MRI was abnormal in 54 (67%). Follow up of those patients with an abnormal MRI revealed progression to clinically definite multiple sclerosis in 45 out of 54 (83%), of whom 11 (20%) had relapsing/remitting disease (EDSS > 3), 13 (24%) secondary progressive and 21 (39%) benign (relapsing/remitting with EDSS 3) disease. For those with a normal MRI progression to clinically definite multiple sclerosis occurred in only three out of 27 (11%), all benign. There was a significant relationship between the number of lesions at presentation and both EDSS = 0.45, P < 0.001) and the type of disease at follow-up (P < 0.0001). Brain MRI at presentation with a clinically isolated syndrome is predictive of the long-term risk of subsequent development of multiple sclerosis, the type of disease and extent of disability.
- Publication
Brain: A Journal of Neurology, 1998, Vol 121, Issue 3, p495
- ISSN
0006-8950
- Publication type
Article
- DOI
10.1093/brain/121.3.495