MS risk seems varied after acute fulminant demyelinating disease

Last Updated: 2007-11-07 14:34:32 -0400 (Reuters Health)

NEW YORK (Reuters Health) – Patients with acute fulminant demyelinating disease (ADEM) show a variety of manifestations and do not demonstrate uniform progression to multiple sclerosis (MS), according to French researchers.

As Dr. Jerome de Seze told Reuters Health, "We retrospectively studied 60 patients and found some differences concerning the risk of evolution to clinically definite MS after a first demyelinating episode suggestive of ADEM."

In the October issue of the Archives of Neurology, Dr. de Seze of the University of Strasbourg and colleagues note that they went on to exclude 6 of these patients with multiphasic ADEM. Over a median of 3.1 years, 35 of the remaining patients were classified as having monophasic ADEM and the other 19 as having clinically definite MS.

The researchers found that 84% of MS patients had oligoclonal bands in the CSF compared to 20% of ADEM patients. ADEM patients were more likely to have gray matter involvement (60%) than the MS patients (11%). In addition, patients with ADEM were more likely to have neurological signs atypical of MS than was the case for the MS group (74% versus 42%).

Using any 2 of these 3 criteria, the researchers were able to correctly classify 83% of the ADEM group and 95% of those with MS.

"These findings," Dr. de Seze concluded, "lead us to propose criteria that should now be tested in a larger, prospective cohort study."

Arch Neurol 2007;64:1426-1432.