Predictive factors for multiple sclerosis in patients with clinically isolated spinal cord syndrome.
OBJECTIVE
To identify predictors of conversion to definite multiple sclerosis (MS) in patients with a cord clinically isolated syndrome.


METHODS
The predictive values for conversion to MS of clinical, magnetic resonance imaging (MRI) and cerebrospinal fluid (CSF) variables in 114 patients with acute partial myelitis confirmed by a spinal cord lesion on MRI were studied. Other causes of cord syndromes were excluded.


RESULTS
MS was diagnosed in 78 patients (86%) during 4.0 ± 1.9 years of follow-up. Some 67 of these patients had a second clinical episode. The diagnosis of isolated myelitis was maintained for 36 patients, 78% of whom (28 cases) were followed for at least 2 years, comparable to the MS patients. Age, bladder involvement, ≥ 2 cord lesions on MRI, ≥ 9 brain lesions, ≥ 3 periventricular lesions and intrathecal IgG synthesis predicted conversion to clinically definite MS. Multivariate logistic analysis identified three predictors of MS diagnosis: age ≤ 40 years, inflammatory CSF and ≥ 3 periventricular lesions on brain MRI.


CONCLUSIONS
Two out of three baseline factors (age, periventricular lesions and inflammatory CSF) predicted conversion to MS with better accuracy than the revised McDonald criteria for dissemination in space.
Services de Neurologie et de Neuro-imagerie, Hôpital Pellegrin, CHU de Bordeaux, 33076, Bordeaux cedex, France.
Aurélie
A
Ruet
Mathilde S A
MS
Deloire
Jean-Christophe
JC
Ouallet
Sandrine
S
Molinier
Bruno
B
Brochet
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D015415:Biomarkers / Q000134:cerebrospinal fluid; D001921:Brain / Q000276:immunology / Q000473:pathology; D003711:Demyelinating Diseases / Q000134:cerebrospinal fluid / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005602:France; D006801:Humans; D018836:Inflammation Mediators / Q000134:cerebrospinal fluid; D016015:Logistic Models; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000134:cerebrospinal fluid / Q000175:diagnosis / Q000209:etiology*; D016017:Odds Ratio; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013116:Spinal Cord / Q000276:immunology / Q000473:pathology; D013997:Time Factors; D055815:Young Adult
D015415:Biomarkers; D018836:Inflammation Mediators