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Polyregional and hemispheric syndromes: a study of these uncommon first attacks in a CIS cohort

Department of Neurology, Unit of Clinical Neuroinmunology, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain, esclerosismultiple{at}vhebron.net

M. Tintoré

Department of Neurology, Unit of Clinical Neuroinmunology, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain

A. Rovira

Deparment of Radiology, Magnetic Resonance Unit, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain

J. Rio

Department of Neurology, Unit of Clinical Neuroinmunology, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain

C. Nos

Department of Neurology, Unit of Clinical Neuroinmunology, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain

E. Grivé

Deparment of Radiology, Magnetic Resonance Unit, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain

N. Téllez

Department of Neurology, Unit of Clinical Neuroinmunology, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain

M. Comabella

Department of Neurology, Unit of Clinical Neuroinmunology, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain

X. Montalban

Department of Neurology, Unit of Clinical Neuroinmunology, Hospital Universitari Vall d'Hebron, Universitat Autonoma (UAB), Barcelona, Spain

Clinically isolated syndromes (CIS) classically refer to optic neuritis (ON), brainstem or spinal cord syndromes. Less common first episodes suggestive of central nervous system (CNS) demyelination, such as hemispheric or clinically polyregional syndromes, have been only slightly studied. The aim of this study was to describe these CIS topographies in our cohort of patient with a CIS. We evaluated 320 patients with a CIS, and classified the topographies of the attacks according to clinical symptoms only into CIS of the optic nerve (123), brainstem (78), spinal cord (89), hemispheric (6), polyregional (12) or undetermined (12) topographies. Patients underwent brain MRI within three months of their first attack, and again 12 months later. Conversion to multiple sclerosis (MS), determined either clinically or by magnetic resonance imaging (MRI), was evaluated according to topography. Hemispheric and polyregional syndromes were closer to brainstem or spinal cord syndromes than ON in clinical and MRI conversion terms, although a statistical analysis was not performed because of the small number of patients. There are differences between several studies in the definition, and, therefore, the prevalence of these so-called atypical CIS. Consensus on the denomination and definition of these syndromes must be reached. Multiple Sclerosis 2007; 13: 731-736. http://msj.sagepub.com

Key Words: clinically isolated syndromes • hemispheric • multifocal • multiple sclerosis • polyregional

This version was published on July 1, 2007

Multiple Sclerosis, Vol. 13, No. 6, 731-736 (2007)
DOI: 10.1177/1352458506074178


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