To describe factors associated with patients' employment with Central Nervous System Inflammatory demyelinating diseases (CNS-IDD).

CNS-IDD can manifest a wide range of symptoms, from fatigue to more severe manifestations, such as weakness, all of which can significantly impact patients' daily functioning. In Thailand, healthcare and employment policies differ from those in previous studies, which may offer different perspectives on the impact of the diseases.

This questionnaire-based study, conducted at a tertiary hospital's Neurology clinic in 2023-2024, examined employment loss (EL), reduced employee hours (RH), and Loss of income (LI). A retrospective chart review was conducted to obtain patients' clinical information. Binary logistic regression was employed for data analysis.

Total 204 IDD patients (Multiple sclerosis: 71, Neuromyelitis optica spectrum disorder: 98, Myelin oligodendrocyte glycoprotein antibody-associated disease: 13, others: 22) were recruited with a median age of 46.0 years (IQR: 36.0-57.8); 82.84% (169/204) were female. Increased EDSS correlated with higher LI (OR 1.18, 95% CI 0.99-1.43) and EL (OR 1.19, 95% CI 1.04-1.36). Disease relapse increased RH (OR 2.84, 95% CI 1.08-7.43). Elevated pain scale linked to increased LI (OR 4.62, 95% CI 1.16-18.32). Fatigue is associated with higher LI (OR 3.25, 95% CI 1.19-8.84), EL (OR 3.28, 95%CI 1.58-6.79), and RH (OR 2.61, 95% CI 1.35-5.06). Transverse myelitis increased EL (OR 2.33, 95%CI 1.03-5.31). Increasing age is associated with higher RH (OR 1.04, 95%CI 1.02-1.07).

The study emphasizes the importance of a holistic approach to managing IDD, considering its impact on various aspects of patients' lives, including employment and income. Prioritizing disease control, specifically managing disability, relapses, pain, and fatigue, is crucial for solving employment-related challenges.