Unexpected multiple sclerosis: follow-up of 30 patients with magnetic resonance imaging and clinical conversion profile

  title={Unexpected multiple sclerosis: follow-up of 30 patients with magnetic resonance imaging and clinical conversion profile},
  author={Christine Lebrun and Caroline Bensa and Marc Debouverie and J{\'e}r{\^o}me de Seze and S Wiertlievski and Bruno Brochet and Pierre Clavelou and David Brassat and Pierre Labauge and Etienne Roullet},
  journal={Journal of Neurology, Neurosurgery, and Psychiatry},
  pages={195 - 198}
  • C. Lebrun, C. Bensa, E. Roullet
  • Published 17 January 2008
  • Medicine, Psychology
  • Journal of Neurology, Neurosurgery, and Psychiatry
The concept of preclinical multiple sclerosis is now well recognised, and a diagnosis of silent brain T2 lesions is frequent because of the ease of performing MRI. Nevertheless, patients with incidental brain MRI fulfilling Barkhof– Tintoré criteria are more rare. We report a descriptive retrospective study of clinical and 5 year MRI follow-up in patients with subclinical demyelinating lesions fulfilling MRI Barkhof–Tintoré criteria with a normal neurological examination. 30 patients were… 
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Examination of pejorative markers for clinical conversion showed that sex, number of T2 lesions, presence of oligoclonal bands, and IgG index were not statistically different in patients with MS determined by MRI compared with clinically definite MS.
[Radiologically isolated syndrome: multiple sclerosis based solely on MRI findings?].
The radiologically isolated syndrome has to be classified as a possible preliminary phase of the clinical manifestation of MS in a subgroup of patients and entails in-depth therapeutic considerations.
Multiple sclerosis risk in radiologically uncovered asymptomatic possible inflammatory-demyelinating disease
Patients with RAPIDD develop MS at a similar rate to treated patients (and less frequently than placebo groups) with clinically isolated syndromes from prior randomized controlled studies.
Radiologically isolated syndrome – incidental magnetic resonance imaging findings suggestive of multiple sclerosis, a systematic review
Management has to be individualised, but initiation of disease modifying therapy is controversial and not recommended outside of clinical trials since its effects have not been studied in RIS.
Incidental demyelinating inflammatory lesions in asymptomatic patients: a Brazilian cohort with radiologically isolated syndrome and a critical review of current literature.
It is demonstrated that, although some individuals did not exhibit progression over a lengthy follow- up period, most patients will progress clinically or radiologically in the initial years of the follow-up (83.3%).
Role of MRI criteria and OB for diagnosing multiple sclerosis in patients presenting with clinically isolated syndromes
The paper by Zipoli and coworkers could provide clinically relevant information for the assessment of patients referred with a suspicion of MS in three different clinical scenarios: 1) Patients presenting with CIS typical of MS and MRI fulfilling 3–4 Barkhof MRI criteria: In terms of predicting conversion to CDMS, it has recently been shown that OBs are an independent risk factor resulting in an almost two-fold increased risk of having a second attack in all patients, independent of MRI.
Incidental MRI anomalies suggestive of multiple sclerosis
Individuals with MRI anomalies highly suggestive of demyelinating pathology, not better accounted for by another disease process, are very likely to experience subsequent radiologic or clinical events related to multiple sclerosis.
Conversion from Radiologically Isolated Syndrome to Multiple Sclerosis
The conversion rates from RIS to definite MS in these participants are high and intensive follow-up and intervention strategies are recommended for these high-risk individuals.
Radiologically isolated syndrome in children
Children with RIS had a substantial risk of subsequent clinical symptoms and/or radiologic evolution and the presence of oligoclonal bands in CSF and spinal cord lesions on MRI were associated with an increased risk of a first clinical event.
Radiologically isolated syndrome or subclinical multiple sclerosis: MAGNIMS consensus recommendations
Expert recommendations are provided that can help distinguish between subjects with low risk of developing MS and those that can be diagnosed with subclinical MS, and for the management of subjects stratified by risk for a future demyelinating event.


Sequential magnetic resonance imaging follow-up of multiple sclerosis before the clinical phase
The incidental discovery of white matter changes on MRI and their follow-up in a patient three years before the first neurological event (optic neuritis) of multiple sclerosis is reported.
In patients who first present with isolated syndromes suggestive of multiple sclerosis, the increases in the volume of the lesions seen on magnetic resonance imaging of the brain in the first five years correlate with the degree of long-term disability from multiple sclerosis.
The significance of brain magnetic resonance imaging abnormalities at presentation with clinically isolated syndromes suggestive of multiple sclerosis. A 5-year follow-up study.
Brain MRI at presentation with a clinically isolated syndrome suggestive of multiple sclerosis is a powerful predictor of the clinical course over the next 5 years, and an ability to detect other sometimes treatable disorders which can also cause such syndromes suggests that MRI is the investigation of choice in evaluating this group of patients.
Isolated demyelinating syndromes: comparison of different MR imaging criteria to predict conversion to clinically definite multiple sclerosis.
The four dichotomized MR imaging parameters proposed by Barkhof et al are more specific and accurate than the criteria proposed by Paty et al or Fazekas et al for predicting conversion to clinically definite multiple sclerosis.
Tuberculoma of the brain: a series of 16 cases treated with anti-tuberculosis drugs.
  • M. Idris, T. Sokrab, S. M. Mirgani
  • Medicine
    The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease
  • 2007
Early empirical trial of anti-tuberculosis drugs for intracranial tuberculoma even after a presumptive diagnosis is advocated, particularly in areas where the infection is endemic.
Comparison of MRI criteria at first presentation to predict conversion to clinically definite multiple sclerosis.
It is concluded that a four-parameter dichotomized MRI model including gadolinium-enhancement, juxtacortical, infratentorial and periventricular lesions best predicts conversion to clinically definite multiple sclerosis.
Familial multiple sclerosis: MRI findings in clinically affected and unaffected siblings.
The results demonstrate the occurrence of subclinical demyelination in asymptomatic siblings of MS patients and stress the importance of clinical follow up and MRI studies of the first-degree relatives when classifying them as healthy in family studies.
Unsuspected multiple sclerosis in patients with psychiatric disorders: a magnetic resonance imaging study.
The subjects with brain white matter hyperintensities consistent with MS were most commonly diagnosed with affective illness and had a significantly longer length of hospital stay during the index admission, a greater number of past psychiatric admissions, and a greater prevalence of brain atrophy.
Mechanisms of disability progression in primary progressive multiple sclerosis: are they different from secondary progressive multiple sclerosis?
  • R. Rudick
  • Medicine, Psychology
    Multiple sclerosis
  • 2003
The PPMS case reported by McDonnell and colleagues occurred in an MS patient who had evolving MRI lesions characteristic of RRMS 10 years before clinical presentation with PPMS, suggesting that PPMS can represent SPMS without initial symptoms, and in that regard, the case blurs the nosological distinction between PPMS and SPMS.