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Atypical clinical features as a presentation of multiple sclerosis
Author(s): ,
C. Pita
Affiliations:
Multiple Sclerosis Clinic, University Center of Neurology, “Dr. J.M. Ramos Mejía” Hospital, Buenos Aires, Argentina
,
B. Silva
Affiliations:
Multiple Sclerosis Clinic, University Center of Neurology, “Dr. J.M. Ramos Mejía” Hospital, Buenos Aires, Argentina
,
R. Alonso
Affiliations:
Multiple Sclerosis Clinic, University Center of Neurology, “Dr. J.M. Ramos Mejía” Hospital, Buenos Aires, Argentina
O. Garcea
Affiliations:
Multiple Sclerosis Clinic, University Center of Neurology, “Dr. J.M. Ramos Mejía” Hospital, Buenos Aires, Argentina
ECTRIMS Online Library. Pita C. Oct 12, 2018; 228856; P1014
Cecilia Pita
Cecilia Pita
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Abstract: P1014

Type: Poster Sessions

Abstract Category: Clinical aspects of MS - MS symptoms

Introduction: The atypical clinical characteristics or clinical "red flags" in Multiple Sclerosis (MS) were described to guide on the possibility of an alternative diagnosis and occur with low frequency at the beginning of MS.
Aim: to describe the clinical and demographic characteristics of patients with MS who debuted with atypical symptoms and to estimate the sensitivity, specificity and positive predictive value (PPV) for MS diagnosis in this group of patients.
Methods: Retrospective analysis of clinical records of patients who attended to our center for demyelinating diseases between 2000 and 2018. Were recorded: patients who debuted with typical and atypical symptoms of MS, patients with MS considering McDonald 2017 criteria, type of initial symptom, time to second relapse and presence or absence of pseudotumoral lesions on MRI. A descriptive and inferential analysis was performed using the chi square test and sensitivity, specificity and PPV was calculated.
Results: Of 1017 patients, 602 (59,1 %) had MS, of which 22 (3,65 %) had an atypical clinical presentation. 54,5% were women. The mean age was 29 years. The most common atypical symptom was peripheral facial nerve palsy (27%) followed by painless optic neuritis (18%) and encephalopathy (18%). All patients with encephalophaty had pseudotumoral lesions on their MRI. Mean time to diagnosis was 36 months, and to second relapse 30 months. 23% of patients had pseudotumoral lesions on MRI. The PPV for atypical onset was 6,14 % ; p < 0.001 (X2). Sensitivity and specificity of this symptoms to MS diagnosis were 3,65 % and 19 %, respectively.
Conclusion: Although there are cases in which atypical symptoms are a form of MS presentation, as shown in this work, other diseases must be excluded taking into account the low sensitivity, specificity and PPV of them.
Disclosure: There are no conflict of interest of these authors for this work.

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