Spinal cord imaging in clinically isolated syndrome

 
Post new topic   Reply to topic    msspeaks Forum Index -> MS - RESEARCH, ARTICLES, ABSTRACTS, DISCUSSION
View previous topic :: View next topic  
Author Message
agate
Site Admin


Joined: 17 May 2006
Posts: 5694
Location: Oregon

PostPosted: Fri Feb 01, 2013 5:36 pm    Post subject: Spinal cord imaging in clinically isolated syndrome Reply with quote

From Journal Watch Neurology, February 1, 2013:

Quote:
Spinal Cord Imaging in Clinically Isolated Syndrome

Spinal cord imaging for nonspinal demyelinating presentations will allow diagnosis of multiple sclerosis in one out of seven patients.

Spinal cord imaging is typically routine in demyelinating syndromes when symptoms and signs indicate spinal cord disease. However, spinal cord imaging is less frequently included for clinically isolated syndromes (CIS) of the cerebrum, optic nerve, or brainstem and cerebellum.

To determine the impact of cord imaging on diagnosis of multiple sclerosis (MS), investigators recruited 121 patients with monofocal CIS (63 referable to the spinal cord, 58 with nonspinal presentations), at least 24 months of follow-up, and both brain and spinal cord magnetic resonance imaging (MRI) at baseline. Spine imaging included sagittal T2-weighted and proton-density sequences of the entire cord. At baseline, 82 patients (67.8%) had focal lesions in the spinal cord; 31 of these patients had a nonspinal CIS. Mean follow-up was 5 years (range, 2–10 years).

At initial presentation, 36 patients fulfilled 2010 McDonald criteria for MS (JW Neurol Jan 25 2011). Six additional patients with nonspinal presentations would meet McDonald criteria if spinal cord imaging were included. The odds ratio for conversion from CIS to clinically definite MS (CDMS) was 3.53 for patients with versus those without baseline spinal cord lesions, and the time to conversion was significantly shorter for those with spinal cord lesions. In the nonspinal presentation subgroup, the odds ratio for CDMS conversion was 6.48 with versus without spinal cord lesions.

Comment:

Diagnosis of CDMS requires dissemination in space and time, which can sometimes be based on a single MRI if there are simultaneous enhancing and nonenhancing lesions in an asymptomatic location. Many neurologists are comfortable recommending treatment for a patient with CIS without additional spinal cord imaging to meet criteria for CDMS. For those reluctant to begin treatment early, cord imaging can lead to more definite diagnosis and prognosis for a second event.

— Robert T. Naismith, MD

Citation(s):

Sombekke MH et al. Spinal cord lesions in patients with clinically isolated syndrome: A powerful tool in diagnosis and prognosis. Neurology 2013 Jan 1; 80:69.

Back to top
View user's profile Send private message
Display posts from previous:   
Post new topic   Reply to topic    msspeaks Forum Index -> MS - RESEARCH, ARTICLES, ABSTRACTS, DISCUSSION All times are GMT - 7 Hours
Page 1 of 1

 
Jump to:  
You can post new topics in this forum
You can reply to topics in this forum
You can edit your posts in this forum
You can delete your posts in this forum
You cannot vote in polls in this forum
Create your own free forum now!
Terms of Service Purchase Ad Removal Forum Archive Report Abuse