Prediction of Multiple Sclerosis after Childhood Isolated Optic NeuritisElpers C1*, Amler S2, Grenzebach U3, Allkemper T4, Fiedler B1, Schwartz O1, Meuth SG5 and Kurlemann G1
- *Corresponding Author:
- Christiane Elpers
University Children’s Hospital Muenster
General Pediatrics and Neuropediatric Department-Albert-Schweitzer-Campus 1
48149 Muenster, Germany
E-mail: [email protected]
Received date: November 18, 2015 Accepted date: November 30, 2015 Published date: December 18,2015
Citation: Elpers C, Amler S, Grenzebach U, Allkemper T, Fiedler B, et al. (2015) Prediction of Multiple Sclerosis after Childhood Isolated Optic Neuritis. Int J Pediatr Neurosci 1:103.
Copyright: © 2015 Elpers C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Isolated optic neuritis in adults (ON) is the most common initial manifestation of multiple sclerosis (MS). Conversion to MS after childhood ON is not well determined. We aimed to identify risk factors predicting MS following ON and to develop risk profiles with adjusted clinical follow-up based on current diagnostic tools. Medical records of 42 cases with isolated ON between 1970 and 2005 were analysed. In 2006 and 2007 all patients received a clinical follow-up investigation including ophthalmological and neurological examination, visual evoked potentials (VEPs), somatosensory evoked potentials (SEPs) and cerebral magnetic resonance imaging (cMRI). Investigation was performed to a mean follow-up of 18 years (3-38 years). 14% of all patients showed MS-like lesions in cMRI. Additional neurologic symptoms or abnormal cMRI at initial presentation indicating dissemination in space significantly altered the risk of MS (OR 16.0, 95% CI [1.5; 176.5], p = 0.020), (OR 4.6, 95% CI [0.7; 31.0], respectively). Severe visual loss and funduscopic affection reduced the likelihood for progression to MS (OR 0.2, 95% CI [0.0; 1.5]). Children presenting with isolated ON, neurological impairment at onset or especially coordinative dysfunction at follow-up and demyelinating lesions in cMRI at disease onset were at high risk for the development of MS.