Optic Neuritis as the First Manifestation of Multiple Sclerosis

Overview

Background:
Opticneuritis(ON)is as the initialmanifestation ofmultiple sclerosis(SM) a favourable prognostic factor during the subsequent course. Objective: Toassess the ratio of ON at the onset of SM in the authors patients and to assessaccording to clinical criteria the form of disease and degree of functional inability,expressed by Kurtzke s EDSS scale. Patients and methods: In a retrospectiveanalysis of patients with clinically defined and probable SM (Poser s criteria))hospitalized at the neurological clinic in 1987-2000 the authors investigated theincidence of ON in relation to the course and form of SM. In individual patientsthey evaluated the age at the onset of the first manifestations of SM, the form,duration and degree of functional inability in EDSS. These findings were comparedin groups of patients with incipient ON and without ON at the onset of SM(non-ON)Results:ONasanisolated initial symptomofSMwas present in29(18.2%)of the total number of 159 patients. The mean age at the time of the initial ON was27.9 yearswhich is as compared with the non-ON group ofSMpatients by 2.8 yearsless. Patients with isolated ON at the onset had the resulting general affection by2 grades EDDSS lower than the non-ON and it was recorded in 73% cases witha relapse-remitting course of SM. The secondary progressive form of the diseaseaccounted for 27% and the primary progressive form was not found.Conclusion:ONas the initial manifestation ofSMis a favourable prognostic factorduring the subsequent clinical course of the disease.

Key words:
optic neuritis, sclerosis multiplex