Der Einsatz des Markierungsbelegverfahrens im Rahmen einer multizentrischen Studie über die multiple Sklerose

All female patients with Multiple Sclerosis (MS) from an epidemiological area of Southern Lower Saxony completed a questionnaire in connection with a standardized neurological examination. The family status of these 179 patients differed significantly from the expected distribution. MS patients were more often single (observed 24, expected 16.5) and divorced (observed 13, expected 5.3). The degree of disability was higher and the duration of the disease longer for the group of divorced patients. Married, widowed and divorced patients had a lower mean number of children (1.63) than would be expected from the general population (1.91). This difference results from a higher percentage of married women without any children and from the small number of families with more than three children. 204 out of 250 children were born before disease onset, 46 during the disease. The percentage of spontaneous abortions and congenital malformations was similar for the pregnancies before and during the disease. 46 % of the patients in the reproductive age used contraceptive methods, most often oral contraceptives (21 %). The influence of pregnancy and oral contraceptives on the course of the disease was investigated in 446 female patients. In addition to the 179 patients mentioned above, the data of 267 female patients could be gained from a central data pool. In the whole material neither pregnancy nor oral contraceptives had an effect on prognosis – defined as the degree of disability reached after a known period of illness. The patients with pregnancy before disease onset and intake of oral contraceptives during the disease exhibited a higher degree of disability compared to the corresponding groups of “no pregnancy” and “pregnancy during the disease”. Young patients seemed less disabled when taking the pill, a finding which needs further prospective investigation.

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Optic neuritis as an initial symptom in multiple sclerosis

Wikström

Poser

Ritter

2009

Acta Neurologica Scandinavica

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The present study is based on a multicenter documentation system which includes standardized information on a total of 1271 patients with multiple sclerosis (MS). In 441 (34.7 %) cases the optic nerve was involved at the first appearance of the disease, and in 212 (16.6 %) subjects optic neuritis (ON) was the sole initial sign. For all MS patients with ON at the onset of the disease the female to male ratio was 1.3, whereas it was 1.5 for the whole series. The mean age at onset was 2 years lower for patients with initial ON as compared with the whole series (29.0 and 31.1 years, respectively). Correlation of the disability o f the patients t o the duration of the disease revealed the best prognosis for patients with ON as the sole initial sign of MS. The frequency of brainstedcerebellar and pyramidal signs was lowest among these patients at the time of the present examination. The difference was more pronounced during the first years of the disease and disappeared after longer duration. The correlation curves of disability to the present age of the patients confirmed this pattern. Our findings do not support the idea of initial ON as being a favorable sign of the later course. As an initial bout of MS, it may reflect more precisely the mean age of onset of the disease than other signs.

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Der Einsatz des Markierungsbelegverfahrens im Rahmen einer multizentrischen Studie über die multiple Sklerose

Cited by 3 publications

References 18 publications

Clinical data and the identification of special forms of multiple sclerosis in 1271 cases studied with a standardized documentation system

Clinical data and the identification of special forms of multiple sclerosis in 1271 cases studied with a standardized documentation system

Pregnancy, oral contraceptives and multiple sclerosis*

Optic neuritis as an initial symptom in multiple sclerosis

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