ACTA FAC MED NAISS 2010; 27 (2): 69-74

Original article

UDC: 616.83-004 

Clinical and Neurophysiological Features in Patients Presenting Clinically Isolated Syndrome Suggestive on Multiple Sclerosis

 

Dejan Savić¹, Slobodan Vojinović¹ , Stevo Lukić¹ , Ljiljana Savić<sup>2

1</sup>Clinic of Neurology, Clinical Center Niš, Serbia

²Department of Laboratory and Roentgen diagnostics, Healthcare Center Niš, Serbia

SUMMARY

Clinically isolated syndrome suggestive on multiple sclerosis is monophasic clinical presentation with suspected underlying inflammatory demyelinating disease. Clinically isolated syndrome supported with magnetic resonance evidence may present the earliest manifestation of multiple sclerosis. Clinical manifestations are still the basis of the first step in making the diagnosis of multiple sclerosis in patients presenting clinically isolated syndromes. The aim of the study was to find the most frequent clinical and neurophysiological features which characterize patients presenting clinically isolated syndromes suggestive on multiple sclerosis. The examination included the patients investigated and treated at the Clinic of Neurology, Clinical Center Niš, during 2005-2008. The examination involved the patients which fulfilled criteria for clinically isolated syndrome suggestive on multiple sclerosis after detailed investigations. We were looking for clinical presentation and neurophysiological features of the disease. In the examined patients we found clinically monofocal (43,18%) and multifocal presentations (52,27%). Patients with monofocal presentation most frequently showed hemispheric lesion signs (18,18%) and efferent clinical signs (36,36%). Patients with multifocal clinical presentation most frequently showed combined efferent-cerebellar clinical presentation (38,64%). Among single clinical manifestations, the majority of patients showed pyramidal lesion signs (72,72%) and cerebellar syndrome (45,45%). Neurophysiological procedures documented the normal findings in only 11,36% of the examined patients. Patients with clinically isolated syndrome suggestive on multiple sclerosis most frequently present with hemispheric lesion signs, neurophysiologically efferent clinical signs and pyramid lesion signs. Multimodal evoked potentials in these patients found high degree of subclinical and clinical abnormalities, mostly in somatosensitive system.

Key words: multiple sclerosis, clinically isolated syndrome, clinical features, evoked potentials