A Retrospective Analysis Of Clinically Isolated Syndrome

Objective: Disscussing the clinical features of CIS and the characteristics of MRI,cerebrospinal fluid,evoked potentials and their diagnostic value through the comprehensive analysis of clinical characteristics of clinical isolated syndrome(CIS)to atain the early diagnosis of CIS was.Disscussing the related influencing factors of CIS to multiple sclerosis(MS)and neuromyelitis optica spectrum disorders(NMOSD)to predict the prognosis of CIS and give early intervention therapy.Methods: Seventy nine patients with CIS in author’s hospital from 2011-01 to 2017-11 were included,and were divided into the brain group,the spinal cord group,the brainstem group and the optic nerve group according to the first place of onset.Analyze the patients ’ regularity,clinical characteristics,related examination and the expanded disability status SCAL(EDSS).According to the result of conversion,patients were divided into the MS Group,the NMOSD Group and the unconverted group.Analyzed the influence of age,sex,quantity characteristic of lesion and EDSS score for evolution.Statistical analysis was performed using SPSS22,comparison among multiple groups was analyzed by the one way analysis of variance,the influence factors of CIS regression were analyzed by multi-Factor regression analysis,and p<0.05 was considered to be statistically significant.Results: 1.CIS patients to see more women,mostly no obvious inducement,often acute or subacute in onset(82.3%).The most common clinical symptoms of CIS were sensory abnormalities(48.1%),visual disturbance(29.1%)and limb paralysis(24.1%).2.The lesions on brain MRI lesion were usually seen in white matter surround the ventricle(41.7%),brainstem(35.4%),centrum ovate(27.1%),frontal lobe cortex(22.9%),and gray matter could be affected.MRI lesions were mainly found in cervical cord(76.2%),thoracic cord(52.4%)and 33% of the patients had spinal cord lesions extending over 3 vertebral segments.3.There is the statistical difference(p=0.006)between the EDSS of the brain group,the spinal cord group,the brain stem group and the optic nerve group.There is also the statistical difference between the EDSS of the brain group and the Spinal Cord Group(p=0.001),the spinal cord group and the Brain Stem Group(p=0.004),the spinal cord group and the optic Nerve group(p=0.038).4.32 patients(40.5%)of CIS converted into MS,25(31.6%)into NMOSD.Multifactor analysis indicated that more than one lesion(OR=3.401,P=0.038)was risk factor for CIS turning into MS;while female patients(OR=6.469,P=0.026)、age<30(OR=0.198,P=0.027)、Spinal lesions ≥ 3 vertebral segments(OR=47.286,P=0.004)were risk factors for CIS turning into NMOSD.Conclusion: 1.CIS patients to see more women,mostly no obvious inducement to acute or subacute in onset.The clinical manifestations of CIS are diverse and atypical,abnormal sensory,visual disturbance and limb paralysis were most common.2.MRI of the brain and spinal cord is of great significance in the diagnosis of CIS,the brain lesions are mainly distributed in the cerebral hemisphere(including lateral ventricle,centrum ovate,frontal lobe cortex,etc.),brain stem,gray matter is also involvement.Spinal lesions are mainly distributed in the cervical cord and thoracic cord,which can be long segmental myelopathy.3.According to the lesion site different groups compared to the EDSS,spinal cord of CIS patients is higher than other parts of CIS.4.Multi-lesion is valuable to predict CIS converting into MS,while female 、age<30 and spinal lesions ≥ 3 vertebral segments are valuable to predict CIS converting into NMOSD.