Abstract
Multiple sclerosis (MS) is a chronic, immune-mediated and degenerative central nervous system (CNS) disease with well-established diagnostic criteria. Treatment can modify the course of the disease. The objective of this study was to describe the initial symptoms of multiple sclerosis in a Brazilian medical center. Descriptive study, conducted in a Brazilian reference center for multiple sclerosis treatment. Data on 299 patients with confirmed diagnoses of MS were included in the study. Their medical files were evaluated and the data were analyzed. The most common symptom involved the cranial nerves (50.83%) and unifocal manifestation was presented by the majority of this population (73.91%). The mean time between the first symptom and the diagnosis was 2.84 years. Unifocal symptoms correlated with longer time taken to establish the diagnosis, with an average of 3.20 years, while for multifocal symptoms the average time taken for the diagnosis was 1.85 years. Unifocal onset was related to greater diagnostic difficulty. MS is a heterogeneous disease and its initial clinical manifestation is very variable.
Highlights
Multiple sclerosis (MS) is a chronic, immune-mediated and degenerative central nervous system (CNS) disease that leads to injury to myelin and axons and results in different neurological signs and symptoms, with dissemination over space and time.[1]
The diagnosis is made from clinical findings, lesions identified on magnetic resonance imaging (MRI), presence of oligoclonal bands and/ or high levels of immunoglobulin G (IgG) in the cerebrospinal fluid (CSF), as described in the revised McDonald criteria in 2010.2 The most commonly presented form of MS is relapsing and remitting
The average time between the onset of MS symptoms and the diagnosis was 2.84 years, and this time was longer among patients who presented unifocal symptoms (3.20 years) than among those who presented multifocal symptoms (1.85 years)
Summary
Multiple sclerosis (MS) is a chronic, immune-mediated and degenerative central nervous system (CNS) disease that leads to injury to myelin and axons and results in different neurological signs and symptoms, with dissemination over space and time.[1]There are no biological markers for MS. The progressive form can present either at the beginning of the disease (primary progressive), or after years of the relapsing-remitting form (secondary progressive).[3] Despite these known diagnostic criteria, there is difficulty in establishing the diagnosis of MS and its onset is usually neglected since these initial symptoms may resolve spontaneously. This situation leads to delayed diagnosis, which delays the treatment and has a negative impact regarding the speed of progression of the disease, and its prognosis.[4] knowledge of the initial manifestations of MS has great epidemiological value, since it can contribute towards decreasing the time between MS onset and treatment, and may slow the progression of the disease
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