The initial symptoms in multiple sclerosis; clinical and demographic data of Çorum province

Introduction Multiple Sclerosis, which has individual and societal effects such as being observed in young and middle aged people and its long and expensive treatment process, has become an important public health issue. Methodology Between January 2022 and January 2023, 103 patients with MS were evaluated by means of anamnesis, neurological examinations and neuroimaging results. The patients' initial findings upon their MS diagnosis, the duration of diagnosis, their neurological observations in the past month, and their clinical categorization were examined. Results Out of the 103 patients, 70 (67.96%) were female, and 33 (32.04%) were male, which was detected as a female-to-male ratio of 2.12/1. The average age of the patients was 34.41±8.4 years, and the average disease duration was 8±5.8 years. The initial findings in females were as follows; 25 patients (35.7%) had sensory, 13 patients (18.6%) had motor (pyramidal), 17 patients (24.3%) had brain stem-cerebellar, 10 patients (14.3%) had visual impairment, and 5 patients (7.1%) had other findings. The distributions of the initial symptoms in males was as follows; 12 patients (36.4%) were motor (pyramidal), 10 patients (30.3%) were sensory, 5 patients (15.1%) were brain stem-cerebellar, 5 patients (15.1%) had visual impairment, and 1 patient (.3.1%) had other findings. The mean Expanded Disability Status Scale (EDSS) at the time of initial diagnosis was 2.5± 1.5. Among the 60 patients with RRMS who were first diagnosed, the duration elapsed between initial symptom onset and diagnosis was 12.8± 5.7 months. Conclusion Demographic information of the MS patients followed-up in our clinic, their initial complaints, frequency of clinical subtypes, differences between clinical subtypes, their clinical status in the last month, their EDDS at their initial diagnosis and last follow-up are presented. As this represents the first data on the epidemiology of MS in our city, we believe it will contribute to the national data of Turkey and help raise MS awareness among clinicians.

Keywords:

multiple sclerosis symptom, disability,

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Rodríguez Murúa S, Farez MF, Quintana FJ. The immune response in multiple sclerosis. Annu Rev Pathol. 2022;17:121-139.
Travers BS, Tsang BKT, Barton JL. Multiple sclerosis: diagnosis, disease-modifying therapy and prognosis. Aust J Gen Pract. 2022;51:199–206.
Walton C, King R, Rechtman L, et al. Rising prevalence of multiple sclerosis worldwide: insights from the atlas of MS, third edition. Mult Scler J. 2020;26:1816–1821.
Wijnands JM, Zhu F, Kingwell E, et al. Five years before multiple sclerosis onset: phenotyping the prodrome. Mult Scler. 2019;25:1092–1101.
Zhao Y, Wijnands JMA, Högg T, et al. Interrogation of the multiple sclerosis prodrome using high-dimensional health data. Neuroepid. 2020;54:140–147.
Browne P, Chandraratna D, Angood C, et al. Atlas of Multiple Sclerosis 2013: a growing global problem with widespread inequity. Neurology. 2014;83(11):1022-1024.
Ghanaatian N, Lashgari NA, Abdolghaffari AH, et al. Curcumin as a therapeutic candidate for multiple sclerosis: Molecular mechanisms and targets. J Cell Physiol. 2019;234 (8):12237–12248.
Goris A, Vandebergh M, McCauley JL, Saarela J, Cotsapas C. Genetics of multiple sclerosis: lessons from polygenicity. Lancet Neurol. 2022; 21: 830-842
Patsopoulos NA, Barcellos LF, Hintzen RQ, et al. Fine-mapping the genetic association of the major histocompatibility complex in multiple sclerosis: HLA and non-HLA effects. PLoS Genet. 2013;9(11):e1003926.
Ward M, Goldman MD. Epidemiology and pathophysiology of multiple sclerosis. Continuum (Minneap Minn) 2022;28(4):988–1005.
Ochi H. Role of B cells in the pathogenesis of multiple sclerosis. Clin Exp Neuroimmunol. 2021; 12:220–227.
Thompson AJ, Banwell BL, Barkhof F, et al. Diagnosis of multiple sclerosis: 2017 revisions of the McDonald Criteria. Lancet Neurol. 2018;17(2):162-173.
Lucchinetti CF, Popescu BF, Bunyan RF, et al. Inflammatory cortical demyelination in early multiple sclerosis. N Engl J Med. 2011;365(23):2188- 2197.
Frischer JM, Bramow S, Dal-Bianco A, et al. The relation between inflammation and neurodegeneration in multiple sclerosis brains. Brain. 2009;132(5):1175-1189.
Westerlind H, Stawiarz L, Fink K, Hillert J, Manouchehrinia A. A significant decrease in diagnosis of primary progressive multiple sclerosis: a cohort study. Mult Scler. 2016;22:1071-1079.
Efendi H, Kuşcu DY, eds. Multipl skleroz tanı ve tedavi rehberi. Galenos Yayınevi, Istanbul, 2018.
Lublin FD, Reingold SC, Cohen JA, et al. Defining the clinical course of multiple sclerosis: The 2013 revisions. Neurology. 2014; 83, 278–286.
EM Frohman, TC Frohman, DS Zee, R McColl, S. Galetta. The neuro-ophthalmology of multiple sclerosis. Lancet Neurol. 2005;4(2):111–121.
Frohman EM, Zhang H, Dewey RB, et al. Utility of positional and particle repositioning maneuvers. Neurology. 2020; 55(10): 1566–1569.
Compston A, Coles A. Multiple sclerosis. Lancet (London, England). 2008;372(9648): 1502–1517.
Bradley WG, Daroff RB, Fenichel GM, Jankovic J, eds. Neurology in Clinical Practice. Elsevier, Philadelphia 2008.
DasGupta R, Fowler CJ. Bladder, bowel and sexual dysfunction in multiple sclerosis: management strategies. Drugs. 2003;63(2):153–166.
Lew-Starowicz M, Gianotten WL. Sexual dysfunction in patients with multiple sclerosis. Handb. Clin. Neurol. 2015;130:357–370.
Evlice A, Demir T, Kaleağası C, Özcan F, Demirkıran M. Rare onset symptoms in multiple sclerosis. Acta Clin Belg. 2016;71 (3):154–157.
Spirin NN, Kiselev DV, Karpova MS. Neuropathic pain syndromes in patients with multiple sclerosis. Zh nevrol psikhiatr im SS Korsakova. 2021;121(7):22–30.
Di Stefano G, Maarbjerg S, Truini A. Trigeminal neuralgia secondary to multiple sclerosis: From the clinical picture to the treatment options. J Headache Pain. 2019; 20, 20.
Vecchio M, Chiaramonte R, Di Benedetto P. Management of bladder dysfunction in multiple sclerosis. A systematic review and meta-analysis of studies regarding bladder rehabilitation. Eur J Phys Rehab Med. 2022;58(3):387-396.
Oset M, Stasiolek M, Matysiak M. Cognitive dysfunction in the early stages of multiple sclerosis—how much and how important? Curr Neurol Neurosci Rep. 2020;20:22.
McGinley MP, Goldschmidt CH, Rae-Grant AD. Diagnosis and treatment of multiple sclerosis. JAMA J Am Med Assoc. 2021;325:765–779.
Bulut S, Kılıç H, Demir CF. Yukarı fırat bölgesinde multipl skleroz tanısı ile izlenen hastaların klinik ve demografik özellikleri. Firat Med J. 2011;16:84– 90.