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Predicting multiple sclerosis following isolated optic neuritis in children
Author(s) -
Heussinger N.,
Kontopantelis E.,
Rompel O.,
Paulides M.,
Trollmann R.
Publication year - 2013
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.12184
Subject(s) - medicine , optic neuritis , multiple sclerosis , odds ratio , logistic regression , magnetic resonance imaging , mcdonald criteria , univariate analysis , pediatrics , multivariate analysis , immunology , radiology
Background and purpose Isolated optic neuritis ( ON ) is frequently the initial symptom of multiple sclerosis ( MS ). The aim of our study was to investigate the risk of conversion to MS in children following isolated ON and to evaluate the performance of current diagnostic methods such as cranial magnetic resonance imaging ( cMRI ), visual evoked potentials ( VEP s) and oligoclonal bands in spinal fluid ( OCB ) as predictive factors for MS development. Methods Medical records of 159 patients presenting with acute ON between 2000 and 2010 at the D epartment of P ediatrics, U niversity of E rlangen, were screened; 34 patients with isolated ON were identified. P rogression to MS was defined according to the revised M c D onald criteria 2005. A ge, sex, VEP s, ON type, cMRI , OCB and visual recovery were assessed as predictors of progression to MS using simple logistic regressions. A multiple logistic regression model included variables found to be significant in univariate analyses. Results Abnormal cMRI was associated with an increase in the odds of MS development (odds ratio 20.57; 95% CI 2.16–196.10, P < 0.001), as was positive OCB (odds ratio 12.0; 95% CI 1.29–111.32, P = 0.001). However, only cMRI remained statistically significant in multiple regressions. Conclusions Multiple sclerosis‐like cMRI lesions and OCB are suitable for assessing the risk of progression to MS following isolated ON , as children with both cMRI abnormalities and positive OCB at onset of ON are at high risk of developing MS .