1Fatemeh Sabeti, 1Masoud Etemadifar, 1Negar Ostadsharif
1Isfahan University of Medical Sciences, Isfahan, Iran
Radiologically isolated syndrome (RIS) is currently not a subtype of multiple sclerosis (MS) however, in the individuals with normal neurological examination and no clinical MS signs whose magnetic resonance imaging (MRI) data fulfill MS imaging criteria, RIS is concluded. We aimed to investigate and descriptively report the demographic, clinical and laboratory findings in 41 RIS subjects.
Material(s) and Method(s):
We followed a group of individuals diagnosed with RIS and obtained their demographic and clinical data.
Forty-one RIS patients were included in this study with a mean age of 40.6 ± 8.3 years and a female to male ratio of 4.1:1. We had obtained MRI of these patients (which lead to their RIS diagnosis) for various reasons including: 24 cases due to headache (58.5%), 3 due to dizziness (7.3%), 2 due to syncope (4.8%), 1 due to trauma (2.4%), 1 due to unconsciousness (2.4%) and in 10 cases MRI was taken sporadically (24.3%). We followed these patients for a mean of 5.9 ± 3.1 years and during this time, 10 patients (24.3%) developed MS. First MS symptom of these patients was paresthesia of lower limbs in 6 patients and optic neuritis in 4. During their follow-up period, oligoclonal bands (OCB) were also detected in 3 patients (7.3%). Different medications were also prescribed for these 41 patients (regardless of having developed MS) such as teczifuma in 3 cases (7.3%), sodium valproate in 2 cases (4.8%), rituximab in 2 cases (4.8%), actovex in 1 patient(2.4%), pregabalin in 1 patient (2.4%), divalproex in 1 patient(2.4%) and teriflunomide in 1 patient(2.4%). Spinal MRI was also obtained in these patients and cervical cord lesions was present in 5 cases (12.1%) and thoracic cord lesion was present in 1 (2.4%).
Although this was an observational report and we did not do any data analysis of the patients’ data, the authors conclude that it is necessary to follow RIS patients even for long periods of time in order to catch their MS diagnosis early. Further, it is necessary to investigate each RIS patient’s clinical characteristics (including CSF and spinal MRI) in order to decide on whether to start MS medication earlier rather than later.