The onset of multiple sclerosis in Greece: a single-center study of 1,034 consecutive patients.
OBJECTIVE
The onset of multiple sclerosis (MS) in Greece has not been systematically studied. We sought to provide data on the onset of MS in Greece with detailed information regarding initial symptoms, and to confirm the prognostic significance of demographic and clinical factors at onset.


METHODS
We studied 1,034 consecutive patients with MS and independently assessed 265 patients 'seen at onset'. We used the MS severity score and survival analysis (time to reach an Expanded Disability Status Scale score of 4.0) to evaluate the prognostic significance of factors at onset.


RESULTS
Female-to-male ratio was 1.9:1 and mean age at onset was 30.7 +/- 9.9 years. MS was primary progressive in 9.6%. Initial symptoms were optic neuritis in 20.1%, brainstem dysfunction in 14.7%, dysfunction of long tracts in 49.3%, cerebral dysfunction in 1% and a combination of symptoms in 14.9%. In 'seen at onset' patients, detailed data on initial symptoms are presented. Female gender, earlier age at onset, 'bout onset' and onset with optic neuritis were associated with less severe disease and longer time to disability.


CONCLUSIONS
The onset of MS in Greece is similar to Western populations. Initial symptoms are within the expected spectrum. Prognostic significance of factors at onset is as previously identified.
1st Department of Neurology, University of Athens, Eginitio Hospital, Athens, Greece. gkoutsi2@otenet.gr
G
G
Koutsis
M E
ME
Evangelopoulos
E
E
Andreadou
D
D
Mandellos
G
G
Karachalios
C
C
Potagas
E
E
Karantoni
M
M
Karouli
C
C
Chrysovitsanou
D
D
Vassilopoulos
C
C
Sfagos
D000328:Adult; D017668:Age of Onset; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D055815:Young Adult