The first acute demyelinating event without encephalopathy, termed a clinically isolated syndrome, can manifest with signs and symptoms caused by a single lesion (monofocal clinically isolated syndrome) or with polyfocal features, implicating multiple lesions. It is becoming increasingly recognized that MS affects children and adolescents, with many of these patients receiving the diagnosis and initiating therapy prior to their 18th birthday(2).
To evaluate the clinically isolated syndrome in individuals with early onset of multiple sclerosis.
MATERIALS AND METHOD:
The records of the multiple sclerosis centers in Baghdad teaching hospital have been surveyed. The study enrolled 77 patients who had early multiple sclerosis (onset before age of 18 years), their clinically isolated syndrome data have been analyzed.
Two thirds of the patients were female (a female/male ratio of 1.6:1). Forty eight of the patient where female (62.3%) and twenty nine patients where males (37.7 %). Mean age at onset was 14.95 years. Seven patients where children (age below 10years) (9.1%) and seventeen patients where adolescents (age 10 to 18 years) (90.9%) at onset. The most common presenting clinically isolated syndrome was optic neuritis (35.8%) followed by brain stem lesion. Fifty nine patients had monofocal presentation (76.6%) and eighteen had polyfocal presentation (23.4%). forty seven patients had complete improvement of the clinically isolated syndrome (61.0%), the rest had partial or no improvement.
The most common clinically isolated syndrome of early onset Multiple sclerosis is optic neuritis. monofocal clinically isolated syndrome more than polyfocal. Complete improvement is high.