Abstract Details

Title Long-Term Follow-Up and Results of Patients with MRI Negative Demyelinating Diseases

Topic Multiple Sclerosis

Presentation(s) P5 - Poster Session 5 (5:30 PM-6:30 PM)

Poster/Presentation
Number 15-110

Objective In this study,presenting symptoms,types of course,intravenous methyl prednisolone(IVMP) responses of patients with multiple sclerosis whose initial and follow-up MRI findings were negative,reported with,long-term follow-up and outcomes results.

Background In demyelinating diseases such as multiple sclerosis(MS),Magnetic Resonance Imaging(MRI),cerebrospinal fluid(CSF) results,differential diagnosis methods and follow-up can be diagnosed with clinical findings.

Design/Methods Seventeen patients presenting and coursed with MS-like symptomatology in our clinic(1982-2018),were retrospectively evaluated in terms of age, gender,initial symptoms and at least two MRI(1.5T) findings,duration of disease,first and last Expanded Disease Status Scale (EDSS),CSF oligoclonal bands(OCB),NMO IgG positivity and final diagnosis.

Results Fourteen(82.4%) of the patients were female and 3(17.6%) were male. The mean age of onset of the disease was 28 years. Five (29.4%) patients had sensory,1(5.9%) motor,2(11.8%) sensory and motor,2(11.8%) spinal,5(29,4%) optic neuritis. The first diagnosis was clinically isolated syndrome(CIS);and 2(11.8%) patients were followed with transverse myelitis(symmetric) and 5(29.4%) patients with optic neuritis. When the CSF findings were examined,81.3%(n = 14) were positive for OCB positive,and 17.7%(n = 3) normal. On initial follow-up of patients with normal MRI imaging,MRI revealed MS-compatible lesions and filled McDonald criteria. MRI of 4(23.5%) patients was still negative in 2018. Two patients (11.8%) were converted to Neuromyelitis Optica (NMO) at follow-up and 1(5.9%) patient was still followed-up as CIS. In mean 46 months,50%(n = 7) of the patients with McDonald MS were determined as relapsing remitting MS(RRMS),48%(n = 6) as secondary progressive MS(SPMS). The neurological status of all patients showed complete or partial improvement with IVMP.

Conclusions This study emphasizes the importance of long-term clinical and MRI monitoring of patients with MS-like symptomatology but negative MRI and response to IVMP and that these patients should be assessed for immunotherapy. In addition,this study raises the question of the fact that these patients,whose MRIs are negative and resemble MS in the first 5 years,might be a variant of MS.

Authors/Disclosures
PRESENTER	No disclosure on file
Canan duman ilki	No disclosure on file
Tuncay Gunduz, MD (ISTANBUL UNIVERSITESI NOROLOJI SERVISI)	The institution of Dr. Gunduz has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis Pharmaceuticals. Dr. Gunduz has received research support from Turkish Neuroimmunology Society.
Murat Kurtuncu, MD (Istanbul University)	Dr. Kurtuncu has nothing to disclose.
Mefkure Eraksoy, MD (ISTANBUL UNIVERSITY)	Dr. Eraksoy has nothing to disclose.

��ɫ��

��ɫ��