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Prevalence of oedema of the lower limbs in multiple sclerosis patients: a vascular and lymphoscintigraphic study

Department of Neurology, PA Micone Hospital, Genoa, Italy, csolaro{at}libero.it

M Messmer Uccelli

Italian Multiple Sclerosis Society, Genoa, Italy

G Brichetto

Department of Neurosciences, Ophthalmology and Genetics and Center for Excellence for Biomedical Research, University of Genoa, Italy

G Augello

Department of Neurosciences, Ophthalmology and Genetics and Center for Excellence for Biomedical Research, University of Genoa, Italy

G Taddei

Nuclear Medicine, Department of Diagnostic Imaging, University Hospital, San Martino, Genoa, Italy

F Boccardo

Department of Surgery, Section of Lymphatic Surgery and Microsurgery, San Martino Hospital, Genoa, Italy

F Buffoni

Nuclear Medicine, Department of Diagnostic Imaging, University Hospital, San Martino, Genoa, Italy

C Campisi

Department of Surgery, Section of Lymphatic Surgery and Microsurgery, San Martino Hospital, Genoa, Italy

L Lopes

Italian Multiple Sclerosis Society, Genoa, Italy

M A Battaglia

Department of Physiopathology, Experimental Medicine and Public Health, University of Siena, Italy

G L Mancardi

Department of Neurosciences, Ophthalmology and Genetics and Center for Excellence for Biomedical Research, University of Genoa, Italy

The aim of the study was to evaluate the frequency of oedema of the lower limbs in multiple sclerosis (MS) patients utilizing a multidisciplinary approach. A total of 205 patients with definite MS were included in the study. Seventy-five were male and 130 female, with a mean age of 50.53, mean Expanded Disability Status Scale (EDSS) score of 5.27 and mean disease duration of 16.6 years. Seventy-one patients had a relapsing-remitting (RR) disease course, 85 were secondary progressive (SP) and 49 were primary progressive (PP). Ninety-three patients (45%) showed oedema at the examination. EDSS, disease duration and disease course, but not gender, were statistically different between oedema and non-oedema patients.

Out of 93 patients with oedema, 69 agreed to undergo a vascular examination. Of 69 patients, 45 (65.2%) had a CEAP score (specific rating scale for oedema) of 3 (presence of oedema) and 24 (34.8%) had a score of 4 (presence of a trophic disorder). Out of 69 subjects, 33 agreed to undergo a lymphoscintigraphy, which was normal in only 29 extremities out of 66.

Lower limb oedema is common in MS patients, especially in those with reduced mobility. Early screening is advised in patients with an elevated EDSS.

Key Words: lymphoscintigraphy • multiple sclerosis • oedema

Multiple Sclerosis, Vol. 12, No. 5, 659-661 (2006)
DOI: 10.1177/1352458506070681


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