Causes of delayed diagnosis of multiple sclerosis in egypt

Abstract

Abstract © 2018 Institute of Psychiatry, Ain Shams University Copyright r 2018 Institute of Psychiatry, Ain Shams University. Unauthorized reproduction of this article is prohibited. Background MS is an inflammatory and neurodegenerative disease. Early inflammatory activity might have a profound impact on the risk of developing early disability, and might be a risk factor for early transition into the progressive phase of the illness. However, there are a number of barriers implementing early MS diagnosis and treatment as the patients may delay consulting a physician about their neurological symptoms or may be reluctant to start DMT. Objective The aim of this study is to highlight the causes of delayed diagnosis of multiple sclerosis in Egypt to shorten the time of diagnosis and improve the prognosis for patients with MS. Patients and Methods Retrospective descriptive study .500 Patients coming to multiple sclerosis unit at Ain Shams University hospitals with delayed diagnosis of MS for more than 2 years had been screened. A questionnaire could be applied on 320 patients out of 500. Contacting (direct and via phone calls) the patients for evaluating the causes of delayed diagnosis of MS was done. Results In this study we found number of significant factors adversely affected a timely diagnosis including the age at onset finding that those younger at onset of MS (vs. older) experienced diagnostic delays (P-value = 0.005) and denial of symptoms which was a leading cause for delayed time to first doctor consultation and delayed diagnosis of MS (P-value =0.009). Also there was a correlation between types of MS and delayed diagnosis as we found that PPMS versus RRMS had delayed diagnosis for more than 2 years. Meanwhile, sensory symptoms at onset of the disease were associated with longer diagnostic delay. Although the first specialties the patients visit were ophthalmology and orthopedic services, that the most common Source of referral to a neurologist was suggestion by family and media. Conclusion multiple causes significantly affect time to diagnosis of MS including age at onset of the disease, denial of symptoms sensorial symptoms at the disease onset and referral delay from other specialties.