First clinical inflammatory demyelinating events of the central nervous system in a population aged over 70 years: A multicentre study.


Journal

Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247

Informations de publication

Date de publication:
Feb 2019
Historique:
received: 17 10 2018
revised: 04 12 2018
accepted: 13 12 2018
pubmed: 22 1 2019
medline: 14 6 2019
entrez: 22 1 2019
Statut: ppublish

Résumé

Few data are available regarding patients with very late-onset inflammatory demyelinating events. (VLO-IDE). The aim of this study was to describe the clinical, biological, and radiological characteristics and aetiological diagnosis of very late first inflammatory demyelinating events of the central nervous system. We conducted a national descriptive retrospective multicentre study on a case series of patients aged >70 years at the time of VLO-IDE. Patients were recruited from a national call on behalf of the 'Société Francophone de la Sclérose en Plaques' (French Multiple Sclerosis Society). Twenty-five patients were referred (F:M sex ratio 2.1:1). The most frequent clinical impairment was a spinal cord deficit (23/25), usually severe (disability score, median EDSS 4.5 [2-9.5]). Spinal cord lesions were usually extensive, spanning at least three segments (11/25), and large brain lesions were also observed (lesions >20 mm in 6/25). The final aetiological diagnoses comprised multiple sclerosis (9/25), neuromyelitis optica spectrum disorders (7/25), neurosystemic lupus erythematosus (2/25), transverse myelitis without aetiological diagnosis (6/25) and optic neuritis (1/25). This study highlights a particular phenotype of first clinical inflammatory demyelinating events in predominantly female patients aged >70 years who have severe motor impairment with common longitudinal extensive myelitis and large and common very active radiological inflammatory lesions. Neuromyelitis optica spectrum disorders seem overrepresented.

Sections du résumé

BACKGROUND BACKGROUND
Few data are available regarding patients with very late-onset inflammatory demyelinating events. (VLO-IDE).
OBJECTIVES OBJECTIVE
The aim of this study was to describe the clinical, biological, and radiological characteristics and aetiological diagnosis of very late first inflammatory demyelinating events of the central nervous system.
METHODS METHODS
We conducted a national descriptive retrospective multicentre study on a case series of patients aged >70 years at the time of VLO-IDE. Patients were recruited from a national call on behalf of the 'Société Francophone de la Sclérose en Plaques' (French Multiple Sclerosis Society).
RESULTS RESULTS
Twenty-five patients were referred (F:M sex ratio 2.1:1). The most frequent clinical impairment was a spinal cord deficit (23/25), usually severe (disability score, median EDSS 4.5 [2-9.5]). Spinal cord lesions were usually extensive, spanning at least three segments (11/25), and large brain lesions were also observed (lesions >20 mm in 6/25). The final aetiological diagnoses comprised multiple sclerosis (9/25), neuromyelitis optica spectrum disorders (7/25), neurosystemic lupus erythematosus (2/25), transverse myelitis without aetiological diagnosis (6/25) and optic neuritis (1/25).
CONCLUSIONS CONCLUSIONS
This study highlights a particular phenotype of first clinical inflammatory demyelinating events in predominantly female patients aged >70 years who have severe motor impairment with common longitudinal extensive myelitis and large and common very active radiological inflammatory lesions. Neuromyelitis optica spectrum disorders seem overrepresented.

Identifiants

pubmed: 30665072
pii: S2211-0348(18)30545-5
doi: 10.1016/j.msard.2018.12.016
pii:
doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

309-312

Informations de copyright

Copyright © 2018 Elsevier B.V. All rights reserved.

Auteurs

Noëlle Lavandier (N)

Cabinet de Neurologie, 31 chemin de Sabalcé, 64100 Bayonne, France; Service de Neurologie, CHU de Bordeaux, Place Amélie Raba Léon, F-33076, Bordeaux, France.

Mickaël Bonnan (M)

Service de Neurologie, CH Pau, hôpital François Mitterrand, 4 boulevard Hauterive, 64046 Pau, France.

Clarisse Carra-Dallière (C)

Service de Neurologie, CHU Montpellier, hôpital Gui-de-Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France.

Mahmoud Charif (M)

Service de Neurologie, CHU Montpellier, hôpital Gui-de-Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France.

Pierre Labauge (P)

Service de Neurologie, CHU Montpellier, hôpital Gui-de-Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France.

Jean-Philippe Camdessanche (JP)

Service de Neurologie, CHU Saint-Etienne, hôpital Nord, 42055 Saint-Etienne cedex 2, France.

Gilles Edan (G)

Service de Neurologie, CHU Rennes, hôpital Pontchaillou, 2 rue Henri-Le-Guilloux, 33033 Rennes cedex, France.

Aurore Naudin (A)

CRC-SEP, pôle des neurosciences, et UMR 1043, CHU Toulouse et université Toulouse III, hôpital Purpan, place du Dr Joseph Baylac, TSA 40031, 31059 Toulouse cedex 9, France.

David Brassat (D)

CRC-SEP, pôle des neurosciences, et UMR 1043, CHU Toulouse et université Toulouse III, hôpital Purpan, place du Dr Joseph Baylac, TSA 40031, 31059 Toulouse cedex 9, France.

Jonathan Ciron (J)

Service de Neurologie, CHU Poitiers, hôpital de la Milétrie, 2 rue de la Milétrie, CS90577, 86021 Poitiers cedex, France.

Pierre Clavelou (P)

Service de Neurologie, CHU Clermont-Ferrand, hôpital Gabriel Montpied, BP 69 63003 Clermont- Ferrand cedex 11, France.

Cécile Dulau (C)

Service de Neurologie, CHU de Bordeaux, Place Amélie Raba Léon, F-33076, Bordeaux, France.

Amandine Moroso (A)

Service de Neurologie, CHU de Bordeaux, Place Amélie Raba Léon, F-33076, Bordeaux, France.

Bruno Brochet (B)

Service de Neurologie, CHU de Bordeaux, Place Amélie Raba Léon, F-33076, Bordeaux, France.

Jean-Christophe Ouallet (JC)

Service de Neurologie, CHU de Bordeaux, Place Amélie Raba Léon, F-33076, Bordeaux, France. Electronic address: jean-christophe.ouallet@chu-bordeaux.fr.

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Classifications MeSH