Ashtari Fereshteh, Shaygannejad Vahid, Farajzadegan Ziba, Amin Ali
Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2010 Mar;15(2):94-9.
Few studies have attempted to delineate the clinical profile of multiple Sclerosis (MS) among people of Asia. This study sought to identify the characteristics of early-onset Multiple Sclerosis (EOMS) comparison to adult-onset form (AOMS) in Isfahan, IRAN.
This prospective study was conducted on 104 youths with multiple sclerosis beginning before the age of 16 years and 123 patients with adult-onset multiple sclerosis. Patients were observed for a mean period of 5 years. The common presenting symptoms, MRI finding, course of disease and disability score were compared between the two groups.
The mean onset age of disease in youths and adults were 14 ± 1.9 and 27.7 ± 8.06 years, respectively. Female/male ratio was 4.47:1 in EOMS and 3.92:1 in AOMS, this ratio was 7:1 in early childhood MS (≤ 10 year). The most common presenting symptom was optic neuritis in the EOMS group and paresthesia in AOMS. Optic neuritis was common in AOMS too, but brainstem/cerebellar signs were more common in EOMS than AOMS. Seizure occurred more frequently in EOMS than in the AOMS group (12.6% vs. 1.6%, respectively, p < 0.001). MRI showed that brainstem plaques were more prevalent in the EOMS compared with the AOMS group.
It was concluded that early-onset MS does not significantly differ from adult form in terms of major clinical manifestation and course of disease, however Seizure is more common in EOMS, and brainstem and cerebellar symptoms as presenting symptom are more common.
很少有研究试图描述亚洲人群中多发性硬化症(MS)的临床特征。本研究旨在确定伊朗伊斯法罕早发性多发性硬化症(EOMS)与成人发病型(AOMS)相比的特征。
本前瞻性研究对104例16岁之前发病的青少年多发性硬化症患者和123例成人发病的多发性硬化症患者进行。对患者进行了平均5年的观察。比较了两组患者常见的首发症状、MRI表现、疾病进程和残疾评分。
青少年和成人的平均发病年龄分别为14±1.9岁和27.7±8.06岁。EOMS组的女性/男性比例为4.47:1,AOMS组为3.92:1,在幼儿期MS(≤10岁)中该比例为7:1。EOMS组最常见的首发症状是视神经炎,AOMS组是感觉异常。视神经炎在AOMS中也很常见,但EOMS组脑干/小脑体征比AOMS组更常见。EOMS组癫痫发作比AOMS组更频繁(分别为12.6%和1.6%,p<0.001)。MRI显示,与AOMS组相比,EOMS组脑干斑块更普遍。
得出的结论是,早发性MS在主要临床表现和疾病进程方面与成人型没有显著差异,然而癫痫发作在EOMS中更常见,且脑干和小脑症状作为首发症状更常见。