Peculiarities of Clinical Manifestations of MS in the Debut of the Disease

Background: Despite many years of study of MS, it is a disease with significant clinical variability and unpredictability of the forecast, so the study of the mechanisms of neurological symptoms and variations of the disease has not lost its relevance.

Objectives: Analysis of clinical features of MS in the debut of disease, among the residents of of Almaty.

Methods: We examined 144 patients with a valid multiple sclerosis (MS),verified on the basis on criteria  WI Mc Donald (2001), aged 17 to 50 years (mean age 33,51 ± 9,4 years). To characterize the features of emotional status were used rating scale level of asthenia - a subjective rating scale of asthenia (MFI-20).

Results: Onset of the disease in 40.9%, was observed mainly at the age of 20 to 29 years; proportion of cases aged under 19 years was 13.2%. Debut of MS among all women who were examined falls on the age up to 29 years in 65.7% of cases, and in men older than 30 years in 80% of cases.

The most frequent symptoms at the onset of MS were sensory disorders at 21,52% of patients.

In our study, optic neuritis in second place among the most frequent manifestations of the debut of MS. As an initial symptom, he met in 19.16% of patients, more often in women than in men 23.6% and 5.6% respectively. 

The movement disorders were the first symptoms of the disease in 18.3% of patients.  Less often the initial manifestations of MS were the cerebellar disorders - 13.9% of patients, pelvic floor disorders in the form of urgency to urinate - at 5.6%. In 1.4% of patients at the onset of the only symptom was paresis of the facial nerve. We found a high incidence of asthenic syndrome in these patients. In the study of the samples using a scale MFI-20 found at the time of questioning in 77.5% of patients had a score of more than 60 points, which matches the criteria clinically significant fatigue (p <0,05). While 61.8% of patients (p <0,05) noted the duration of asthenic disorders with the debut of the disease. Asthenic disorders characterized by complaints of painful feeling with the constant feeling of weakness, tiredness, exhaustion, rapid onset of fatigue with minimal load, the need for additional rest, the desire to lie in the daytime, and the rest did not bring significant relief. The overall decline in activity, performance accompanied by some reduction in the mood to dissatisfaction. A sense of physical weakness combined with the exhaustion of mental processes.

Conclusions: We found that in the onset of the disease symptoms often accompany asthenic for PC, causing additional suffering to these patients. The most pronounced emotional personality disorders found in patients with primary progressive disease course. Identifying these signs at a young age, "shimmering" nature of symptoms, change their severity depending on the physical and emotional burden necessitate neurologist suggested the possibility of the development of the PC and make the necessary paraclinical examinations.