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Prognostic Factors of Mikaeloff et al for a Child with Multiple Sclerosis

Description

Mikaeloff et al identified prognostic factors for a child with multiple sclerosis. The authors are from the Kid Sclerose en Plaques Study Group (KIDSEP) in France and Canada.


 

Patient selection: multiple sclerosis with onset before age 16 years

 

Criteria for severe disease:

(1) occurrence of A3 (a third attack) or

(2) severe disability, with disability status scale (DSS) >= 4

 

Parameters:

(1) gender

(2) time between first (A1) and second attack (A2)

(3) childhood-onset multiple sclerosis MRI criteria at onset (presence of lesions perpendicular to the long axis of the corpus callosum and/or presence of well-defined lesions)

(4) severe mental status changes at onset

(5) course

Parameter

Finding

Points

gender

male

1

 

female

1.45

time between first and second attacks

< 12 months (< 1 year)

1.56

 

>= 12 months (>= 1 year)

1

MRI criteria at onset

absent

1

 

present

1.89

severe mental status changes at onset

absent

1.91

 

present

1

course

progressive

2.93

 

not progressive

1

 

potential index =

= PRODUCT(points for all 5 parameters)

 

Interpretation:

• minimum index: 1 (no risk factors present)

• maximum index: 23.9 (all 5 risk factors present)

• The higher the index the greater the risk for early severity.

 

Quartile

Median Value

Probability of Not Having Severe Disease at 3 Years After Onset

1

1.9

53%

2

4.3

42%

3

5.6

25%

4

8.2

7%

from Figure 1, page 1137

 


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Specialty

ICD-10