2Abdullah Al-Asmi, 1Salma Al-Abri, 2Arunodaya R. Gujjar, 2Ahmed Al-Qassabi, 2Haifa Al-Abri
1Internal Medicine Residency Program, Oman Medical Specialty Board (OMSB), Muscat, Oman; 2Neurology Division, Medicine Department, College of Medicine and Health Sciences and Sultan Qaboos University Hospital, Sultan Qaboos University, Muscat, Oman
Multiple sclerosis (MS) is an immune mediated central nervous system demyelinating disorder with a varying disease course, resulting in different degrees of physical disability for affected patients. The current study aimed to present the initial clinical and radiological features of Omani MS patients presenting to a tertiary care center in Oman.
Material(s) and Method(s):
This is a retrospective study where MS patients diagnosed according to McDonald’s diagnostic criteria who attended neurology clinic of Sultan Qaboos University Hospital, Muscat, Oman between 2006 and 2020 were included in the study. Data were collected from the patients’ electronic medical records, including sociodemographic, clinical, neuroimaging, and initial treatment given. The initial disability status of the patients was assessed using the Expanded Disability Status Scale (EDSS).
A total of 155 patients were included with a 2:1 female to male ratio. The mean age at diagnosis was 28.57 ± 7.94 years. The mean duration of symptoms to diagnosis was 1.86 years. MS patients experience a median of 2 relapses (1-7) prior to their first visit to our hospital. Most patients (97.4%) were diagnosed with relapsing-remitting MS (RMS). 84.5% of patients presented with unifocal symptoms. The most common initial symptoms were referred to supratentorial region (34.2%) followed by the optic pathway (33.5%). 94.8% of the patients had EDSS of less than 3.5 by the time they presented to our hospital. Initial brain magnetic resonance (MRI) and cervical MRI were available for analysis in 72 (46.5%) and 47 (30.3%) patients, respectively. For the available MRI brain, 40% had ≥ 20 T2 lesions, while 36.1% had infratentorial lesions. For the available cervical spinal cord MRI, 23.9% had lesions at presentation. The most frequent initial disease-modifying therapy (DMT) used were the injectables (n = 104; 67%), followed by fingolimod (n = 16; 10.3%), Natalizumab (n = 16; 9%) and dimethyl fumarate (n = 4; 2.6%).
The most common initial clinical presentation of Omani MS patients in our center was unifocal symptoms related to the supratentorial lesions. Further studies are needed to include all Oman MS patients from other centers to confirm our findings further.