Alroughani et al identified factors associated with conversion from the clinically isolated syndrome to multiple sclerosis. The authors are from Amiri Hospital, Dasman Diabetes Institute, Ibn Sina Hospital, Kuwait University and Minia University in Kuwait.
Patient selection: clinically isolated syndrome
Outcome: multiple sclerosis diagnosed within the next 2 years, using 2010 revised McDonald criteria
Predictors of progression:
(1) younger age at onset
(2) greater number of lesions seen on MRI of brain and spinal cord (exceeding 3 mm)
Age at onset and risk of progression:
(1) The risk is lowest for a patient >= 30 years.
(2) Patients who progressed had a mean age of 21.6 years +/- 6.2 (15.4 to 27.8). The comparison group had a mean age of 25.6 +/- 6.9 (18.7 to 32.5).
Number of lesions:
(1) The presence of >= 9 lesions was associated with greatest risk for conversion.
(2) The presence of 4-8 lesions showed an increased rate of conversion.
Limitations:
• The progression to multiple sclerosis can occur over decades. In this study conversion occurred in 60%, mostly within a year.
