Premium
STUDIES ON THE NATURAL HISTORY OF MULTIPLE SCLEROSIS 6. Clinical and Laboratory Findings at First Diagnosis
Author(s) -
Kurtzke John F.,
Beebe Gilbert W.,
Nagler Benedict,
Auth Thomas L.,
Kurland Leonard T.,
Nefzger M. Dean
Publication year - 1972
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/j.1600-0404.1972.tb07525.x
Subject(s) - medicine , multiple sclerosis , concordance , neurological examination , pediatrics , mood , physical therapy , surgery , psychiatry
Signs, symptoms, and laboratory findings were presented to describe an early bout of multiple sclerosis (MS). Data were derived from U.S. Army hospitalizations during the World War II period. For 293 men (group A), there had been previous bouts before the one for which they were hospitalized in the Army, whereas for 234 men (group B), this Army hospital bout was the onset bout. Median duration of this Army diagnostic bout was 2 months from onset to neurologic examination. Signs found at neurologic examination were classified into 8 functional systems: pyramidal, cerebellar, brain stem, sensory, bowel and bladder, visual, cerebral, and miscellaneous; symptoms were categorized into 8 equivalent groups. Over‐all dysfunction was graded according to the Disability Status Scale. There was a moderate degree of concordance between signs and symptoms of each type. In every aspect save one, the group A and group B cases were indistinguishable; visual dysfunction was somewhat more prevalent in group A. Involvement at examination was most common in pyramidal (85 %), cerebellar (77 %), brain stem (73 %), and sensory (55 %); less common were bowel and bladder (23%), visual (34%), cerebral (mostly mood change) (21 %), and miscellaneous signs (15 %). Each functional system tended to correlate with over‐all disability in both frequency and severity of involvement. When symptoms were distributed by limbs affected, motor and coordination complaints showed a predilection for lower limbs and a tendency to symmetry, whereas sensory complaints were almost equally common in each body part. Cerebrospinal fluid findings were in accord with those of most series. There was no relationship of any or all CSF abnormalities with total duration of illness, duration of the bout, over‐all disability, or type or severity of any functional system, except for a possible correlation between pyramidal signs and abnormalities of colloidal gold curve, and pyramidal signs and any abnormality of CSF. These data, in addition to detailing an early bout of MS in a nationwide sample of males, also provide the bases for our later efforts to predict the course of illness for the persons affected.