Patients with clinically isolated syndrome conversion to multiple sclerosis: predictive paraclinical tests

Abstract

Introduction Multiple sclerosis (MS) is a chronic autoimmune demyelinating inflammatory disease with a clinical onset which usually manifests as clinically isolated syndrome (CIS) [1]. Approximately 80% of people with CIS convert to MS [2]. Therefore, there is a pressing need to identify the most accurate predictive factors of CIS conversion to MS. Some of which could be magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) and evoked potentials (EP) pathological findings. The problem is of outstanding importance since early MS diagnosis and treatment prevents long-term disability [3]. Aim The aim of this study was to establish which of the paraclinical tests could have the best predictive value of CIS conversion to MS. Methods A retrospective data analysis collected in the Hospital of Lithuanian University of Health Sciences (LUHS) Kaunas Clinics was performed. Eligible patients were adults (aged ≥ 18 years) diagnosed with demyelinating encephalomyelitis with ICD – 10 (International Classification of Diseases Version 10) codes G37.8 (other specified demyelinating diseases of central nervous system), G37.9 (demyelinating disease of central nervous system, unspecified) in the period between January 1st 2015 and January 1st 2020. In clinical practice this diagnosis is called CIS. All analyses were performed using SPSS (Statistical Package for the Social Sciences) version 24.0. Chi Square test was used for comparison between categorical variables. Mann-Witney test was used for comparison between groups. All results were statistically significant when p < 0,05. Results A total of 169 cases were reviewed, 31 cases were excluded due to insufficient data, 138 cases were included in the study. We found that 49 (n=138) patients converted to MS diagnosis (35.5%), other 89 patients (64.5%) were diagnosed with other diseases than MS. We received only 35% of those who converted to MS due to the short time period [...].