Study of profile of patients with clinically isolated syndrome: A hospital based prospective study

 

Shivakumar K Masaraddi^1*, Goutam Ganguly², Alok Pandit³, Arijit Ray⁴

 

Abstract              Background: Clinically isolated syndrome (CIS) describes the first clinical episode of symptoms and signs suggestive of an inflammatory demyelinating disorder of the central nervous system (CNS) It can by mono or multifocal affecting the various parts of the CNS. The present study aimed to evaluate profile of patients with CIS. Materials and Methods: The study was conducted in the Department of Neurology, Bangur Institute of Neuroscinces, Kolkata during the period of Jan 2013 to Dec 2014. A total of 49 cases were included in the study on the basis of inclusion and exclusion criteria. All patients were explained study procedure and consent was obtained. Demographic, clinical and radiological observations were recorded and analyzed. Results: Majority of CIS patients were Females (n=35) compared to males (n=14). Mean age of patients was 25.04 years. Maximum patients of CIS had optic neuritis ((n=38), followed by myelitis (n=6), brainstem/cerebellar (n=2) and multifocal (n=3) presentation. Majority of CIS patients had MRI lesions (n=39/49).Within the optic neuritis group (n=28/39)73.68% had MRI lesions, 100% each in myelitis, brainstem/cerebellar and multifocal subgroups. Within the optic neuritis(n=38/49) which formed the major subgroup presentation, majority had unilateral, painful vision loss with color desaturation, afferent papillary defect, optic disc edema and all showed demyelinating type VEP abnormality.  Conclusion: Clinically isolated syndrome (CIS) is a term that describes a first clinical episode with features suggestive of multiple sclerosis (MS). The present study results conclude that CIS has got female prepondarence, with predeliction for young adults and that optic neuritis forms most common clinical presentation, followed by myelitis, brainstem/cerebellar and multifocal groups. MRI forms the single most important non-invasive tool for diagnosis and prognostication of CIS patients.

Keywords: Brain stem, Clinically Isolated Syndrome, MRI, optic neuritis, Multiple sclerosis, inflammation.