Document Detail

Evolution and long term outcome in patients presenting with large demyelinating lesions as their first clinical event.
MedLine Citation:
PMID:  20678779     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: To describe the long term evolution and outcome of a homogeneous cohort of patients (n=14) with large demyelinating lesions (LDLs) as the first clinical event from a group of idiopathic inflammatory demyelinating diseases of central nervous system.
METHODS: Detailed review of LDLs from December 2002-January 2007 was made. Patients had at least two magnetic resonance imaging (MRI) and minimum follow-up of 2years. The disability was assessed using Estimated Expanded Disability Status Scale (EDSS) and Rappaport Disability Rating Scale (DRS) at onset and last follow-up.
RESULTS: Fourteen consecutive LDL patients (male=7), with mean age 32.7years and mean follow-up of 45.5months were included. Motor deficits (79%) and cognitive symptoms (43%) marked the onset, none had optic neuritis. All except two responded to steroids. Follow-up MRI showed complete resolution in 43%, 57% showing marked reduction in size. On follow-up, 2 relapsed. Mean EDSS and DRS at presentation were 5.93 and 9.07 and at last follow-up were 1.75 and 2.25 (p<0.001).
CONCLUSIONS: Our data suggests that, patients presenting with LDLs as their first clinical event behaves distinctly in their presentation, imaging characteristics, prognosis and long term outcome as compared to MS and ADEM. Albeit significant disability at the onset, these patients show an excellent response to treatment with good functional recovery in long term and rare relapses.
Pandurang R Wattamwar; Neeraj N Baheti; Chandrasekharan Kesavadas; Muralidharan Nair; Ashalatha Radhakrishnan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-08-01
Journal Detail:
Title:  Journal of the neurological sciences     Volume:  297     ISSN:  1878-5883     ISO Abbreviation:  J. Neurol. Sci.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2010-12-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375403     Medline TA:  J Neurol Sci     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  29-35     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier B.V. All rights reserved.
Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, 695011, Kerala, India.
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MeSH Terms
Analysis of Variance
Central Nervous System / pathology*
Cognition Disorders / etiology
Diagnostic Imaging*
Disability Evaluation
Encephalomyelitis, Acute Disseminated / complications,  drug therapy,  radiography*
Longitudinal Studies
Middle Aged
Multiple Sclerosis / complications,  drug therapy,  radiography*
Neurologic Examination / methods
Retrospective Studies
Steroids / therapeutic use
Young Adult
Reg. No./Substance:

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