Comparison of the Clinical Courses of the Opticospinal and Conventional Forms of Multiple Sclerosis in Japan

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  • OSOEGAWA Manabu
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
  • NIINO Masaaki
    Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo
  • TANAKA Masahito
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
  • KIKUCHI Seiji
    Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo
  • MURAI Hiroyuki
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
  • FUKAZAWA Toshiyuki
    Hokuyukai Neurology Hospital, Sapporo
  • MINOHARA Motozumi
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
  • MIYAGISHI Ryuji
    Nishi-Maruyama Hospital, Sapporo
  • TANIWAKI Takayuki
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka
  • TASHIRO Kunio
    Department of Neurology, Hokkaido University Graduate School of Medicine, Sapporo
  • KIRA Jun-ichi
    Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka

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Description

We evaluated the clinical courses of 216 patients with multiple sclerosis (MS) diagnosed according to the recommended diagnostic criteria of McDonald et al (10). Sixty-five patients clinically displaying selective involvement of the optic nerves and spinal cord were classified as opticospinal MS (OS-MS), while the other 151 showing disseminated involvement of the central nervous system were classified as conventional MS (C-MS). The disease duration did not differ significantly between the two subtypes (11.2 years vs. 11.5 years). In addition to a higher age of onset, female preponderance and higher Kurtzke’s expanded disability status scale (EDSS) scores, the OS-MS patients showed a markedly lower frequency of secondary progressive MS than the C-MS patients (4.6% vs. 29.1%, p=0.0001). The EDSS scores of the C-MS patients were significantly correlated with the disease duration, while those of the OS-MS patients were not. Among the C-MS patients, the frequency of secondary progressive MS was significantly more common in patients with a disease duration of more than 10 years than in those with a shorter duration. These results suggest that the irreversible disability in OS-MS is determined by relapses, rather than by chronic progression, whereas C-MS has a similar clinical course to MS in Westerners.

Journal

  • Internal Medicine

    Internal Medicine 44 (9), 934-938, 2005

    The Japanese Society of Internal Medicine

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