Brainstem syndrome at onset is related to an early MS diagnosis in Peru: A national referral center cohort
Background: MS is unpredictable regarding clinical symptoms; however, certain symptoms represent the preferred localization of white matter lesions such as brainstem, spinal cord; or optic nerve. Objectives: To investigate the epidemiological, clinical, and imaging characteristics of MS patients in...
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doaj-d2701224e11b48d69b460b904d53344f2021-10-05T04:20:00ZengElsevierHeliyon2405-84402021-10-01710e08069Brainstem syndrome at onset is related to an early MS diagnosis in Peru: A national referral center cohortCésar Caparó-Zamalloa0Sheila Castro-Suarez1Jaqueline Cortez-Escalante2Wilfor Aguirre-Quispe3Erik Guevara-Silva4Victor Osorio-Marcatinco5María Meza-Vega6Basic Research Center in Dementia and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Neurosonología, Clínica Delgado, Lima, Peru; Corresponding author.Basic Research Center in Dementia and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Global Brain Health Institute, University of California, San Francisco, CA, United StatesBasic Research Center in Dementia and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, PeruBasic Research Center in Dementia and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, PeruBasic Research Center in Dementia and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, PeruBasic Research Center in Dementia and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, PeruBasic Research Center in Dementia and Central Nervous System Demyelinating Diseases, Instituto Nacional de Ciencias Neurológicas, Lima, Peru; Universidad Nacional Mayor de San Marcos, Lima, PeruBackground: MS is unpredictable regarding clinical symptoms; however, certain symptoms represent the preferred localization of white matter lesions such as brainstem, spinal cord; or optic nerve. Objectives: To investigate the epidemiological, clinical, and imaging characteristics of MS patients in a national referral center in Peru, and to evaluate whether the type of symptom at onset relates with the time to making an MS diagnosis. Methods: Retrospective study of MS patients at the Instituto Nacional de Ciencias Neurológicas between January 2010 and December 2018. Four different syndromes were selected for analysis as symptom onset (optic neuritis, brainstem syndrome, myelitis, and others). Results: we identified 268 patients for whom a diagnosis of MS had been given; after excluding misdiagnosed patients (33 Neuromyelitis optica), lost or incomplete records, 121 patients were included. The majority of patients (46.6%) were born in Lima. Female to male ratio was 1.37 to 1, mean age at diagnosis was 31 years. At onset, myelitis was present in 35% of RRMS patients, followed by brainstem syndrome (25%) and optic neuritis (18%). Brainstem syndrome was statistically significant predictor for earlier diagnosis (adjusted HR: 2.09; p = 0.015). Conclusion: Brainstem syndrome as an initial presentation of MS in Peru is related to an earlier diagnosis.http://www.sciencedirect.com/science/article/pii/S2405844021021721Multiple sclerosisBrainstem syndromeEarly diagnosisPeruClinical characteristics |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
César Caparó-Zamalloa Sheila Castro-Suarez Jaqueline Cortez-Escalante Wilfor Aguirre-Quispe Erik Guevara-Silva Victor Osorio-Marcatinco María Meza-Vega |
spellingShingle |
César Caparó-Zamalloa Sheila Castro-Suarez Jaqueline Cortez-Escalante Wilfor Aguirre-Quispe Erik Guevara-Silva Victor Osorio-Marcatinco María Meza-Vega Brainstem syndrome at onset is related to an early MS diagnosis in Peru: A national referral center cohort Heliyon Multiple sclerosis Brainstem syndrome Early diagnosis Peru Clinical characteristics |
author_facet |
César Caparó-Zamalloa Sheila Castro-Suarez Jaqueline Cortez-Escalante Wilfor Aguirre-Quispe Erik Guevara-Silva Victor Osorio-Marcatinco María Meza-Vega |
author_sort |
César Caparó-Zamalloa |
title |
Brainstem syndrome at onset is related to an early MS diagnosis in Peru: A national referral center cohort |
title_short |
Brainstem syndrome at onset is related to an early MS diagnosis in Peru: A national referral center cohort |
title_full |
Brainstem syndrome at onset is related to an early MS diagnosis in Peru: A national referral center cohort |
title_fullStr |
Brainstem syndrome at onset is related to an early MS diagnosis in Peru: A national referral center cohort |
title_full_unstemmed |
Brainstem syndrome at onset is related to an early MS diagnosis in Peru: A national referral center cohort |
title_sort |
brainstem syndrome at onset is related to an early ms diagnosis in peru: a national referral center cohort |
publisher |
Elsevier |
series |
Heliyon |
issn |
2405-8440 |
publishDate |
2021-10-01 |
description |
Background: MS is unpredictable regarding clinical symptoms; however, certain symptoms represent the preferred localization of white matter lesions such as brainstem, spinal cord; or optic nerve. Objectives: To investigate the epidemiological, clinical, and imaging characteristics of MS patients in a national referral center in Peru, and to evaluate whether the type of symptom at onset relates with the time to making an MS diagnosis. Methods: Retrospective study of MS patients at the Instituto Nacional de Ciencias Neurológicas between January 2010 and December 2018. Four different syndromes were selected for analysis as symptom onset (optic neuritis, brainstem syndrome, myelitis, and others). Results: we identified 268 patients for whom a diagnosis of MS had been given; after excluding misdiagnosed patients (33 Neuromyelitis optica), lost or incomplete records, 121 patients were included. The majority of patients (46.6%) were born in Lima. Female to male ratio was 1.37 to 1, mean age at diagnosis was 31 years. At onset, myelitis was present in 35% of RRMS patients, followed by brainstem syndrome (25%) and optic neuritis (18%). Brainstem syndrome was statistically significant predictor for earlier diagnosis (adjusted HR: 2.09; p = 0.015). Conclusion: Brainstem syndrome as an initial presentation of MS in Peru is related to an earlier diagnosis. |
topic |
Multiple sclerosis Brainstem syndrome Early diagnosis Peru Clinical characteristics |
url |
http://www.sciencedirect.com/science/article/pii/S2405844021021721 |
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