Multiple Sclerosis Center, Sheba Medical Center, Tel Hashomer, Israel Institute of Motor Functions, Sheba Medical Center, Tel Hashomer, Israel.
NeuroRehabilitation. 2013;33(3):423-30. doi: 10.3233/NRE-130973.
Factors determining the clinically isolated syndrome (CIS) patient's likelihood of developing multiple sclerosis (MS) are important for the clinician who needs to identify patients warranting immunomodulatory treatments.
To determine whether motor abnormalities found during the initial demyelinating event imply an increased risk of a second event within the first year.
Fifty-two early onset CIS patients, volunteered to participate in the prospective study. Motor parameters collected at onset included gait, balance, lower limb peak isometric strength and fatigue index parameters. At the end of one year, patients were subdivided into two groups, those who had experienced a second demyelinating attack suggestive of MS and those who maintained their clinical status.
Forty-nine patients were included in the final analysis. Within the first year, 24 patients experienced a second attack, while 25 maintained their neurological status. Patients who suffered a second demyelinating attack, demonstrated reduced overall lower limb peak strength compared with patients who maintained their clinical status (411.9 (S.E. = 32.1) vs. 514.8 (S.E. = 34.1). No differences were observed between groups in gait and balance parameters.
An initial demyelinating event characterized by reduced lower limb strength can possibly suggest an increased risk of an early second attack.
决定临床孤立综合征（CIS）患者发展为多发性硬化症（MS）可能性的因素对临床医生很重要，因为他们需要识别需要免疫调节治疗的患者。
确定在最初脱髓鞘事件期间发现的运动异常是否意味着在一年内发生第二次事件的风险增加。
52 名早期 CIS 患者自愿参加前瞻性研究。发病时收集的运动参数包括步态、平衡、下肢等长峰值力量和疲劳指数参数。在一年结束时，将患者分为两组，一组发生第二次提示 MS 的脱髓鞘发作，另一组保持其临床状态。
49 名患者纳入最终分析。在第一年，24 名患者经历了第二次发作，而 25 名患者保持了他们的神经状态。与保持临床状态的患者相比，发生第二次脱髓鞘发作的患者下肢整体峰值力量降低（411.9（S.E. = 32.1）比 514.8（S.E. = 34.1）。两组之间在步态和平衡参数方面没有差异。
以下肢力量降低为特征的初始脱髓鞘事件可能表明早期发生第二次攻击的风险增加。
