Abstract
The clinical features, disease course and long term prognosis of early onset multiple sclerosis (EOMS) are variable. A preponderance of female sex, a high incidence of visual and brainstem symptoms at onset and a relapsing–remitting disease course with slower progression rate all have been considered relatively frequent in this subgroup of MS patients. Unfortunately, follow–up in previous studies has usually been limited to less than 10 years, precluding general statements on the long term evolution and prognosis in EOMS.
In this retrospective study of EOMS with a substantially longer follow–up of 20.8 years, clinical characteristics, disease course and long term prognosis are described in 49 EOMS patients. In a representative subgroup of 28 patients disability was scored using Kurtzke’s Functional System (FS) and Expanded Disability Status Scale (EDSS). The mean period of follow– up for these patients was 28.7 years.
The present study confirms that several specific clinical characteristics can be identified in EOMS patients, such as a mainly relapsing–remitting disease onset and frequent presentation with brainstem– cerebellar dysfunction (28.6 %), pyramidal symptoms (18.4 %) and optic neuritis (14.3%). However, after a long period of follow–up the overall disease course and prognosis do not seem to differ from that in adult onset MS. By consequence a young age at onset in MS cannot be considered a favourable prognostic factor.
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Deryck, O., Ketelaer, P. & Dubois, B. Clinical characteristics and long term prognosis in early onset multiple sclerosis. J Neurol 253, 720–723 (2006). https://doi.org/10.1007/s00415-006-0095-1
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DOI: https://doi.org/10.1007/s00415-006-0095-1