title: Comparison of the clinical courses of the opticospinal and conventional forms of multiple sclerosis in Japan.
abstract: We evaluated the clinical courses of 216 patients with multiple sclerosis (MS) diagnosed according to the recommended diagnostic criteria of McDonald et al (10). Sixty-five patients clinically displaying selective involvement of the optic nerves and spinal cord were classified as opticospinal MS (OS-MS), while the other 151 showing disseminated involvement of the central nervous system were classified as conventional MS (C-MS). The disease duration did not differ significantly between the two subtypes (11.2 years vs. 11.5 years). In addition to a higher age of onset, female preponderance and higher Kurtzke's expanded disability status scale (EDSS) scores, the OS-MS patients showed a markedly lower frequency of secondary progressive MS than the C-MS patients (4.6% vs. 29.1%, p=0.0001). The EDSS scores of the C-MS patients were significantly correlated with the disease duration, while those of the OS-MS patients were not. Among the C-MS patients, the frequency of secondary progressive MS was significantly more common in patients with a disease duration of more than 10 years than in those with a shorter duration. These results suggest that the irreversible disability in OS-MS is determined by relapses, rather than by chronic progression, whereas C-MS has a similar clinical course to MS in Westerners.
authors.affiliation: Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Manabu
authors.initials: M
authors.lastname: Osoegawa
authors.forename: Masaaki
authors.initials: M
authors.lastname: Niino
authors.forename: Masahito
authors.initials: M
authors.lastname: Tanaka
authors.forename: Seiji
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Murai
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fukazawa
authors.forename: Motozumi
authors.initials: M
authors.lastname: Minohara
authors.forename: Ryuji
authors.initials: R
authors.lastname: Miyagishi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Taniwaki
authors.forename: Kunio
authors.initials: K
authors.lastname: Tashiro
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Kira
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000145:classification / Q000209:etiology* / Q000503:physiopathology; D009900:Optic Nerve / Q000503:physiopathology; D012189:Retrospective Studies; D013116:Spinal Cord / Q000503:physiopathology; D013997:Time Factors