Noëlle Lavandier1, Mickaël Bonnan2, Clarisse Carra-Dallière3, Mahmoud Charif3, Pierre Labauge3, Jean-Philippe Camdessanche4, Gilles Edan5, Aurore Naudin6, David Brassat6, Jonathan Ciron7, Pierre Clavelou8, Cécile Dulau9, Amandine Moroso9, Bruno Brochet9, Jean-Christophe Ouallet10. 1. Cabinet de Neurologie, 31 chemin de Sabalcé, 64100 Bayonne, France; Service de Neurologie, CHU de Bordeaux, Place Amélie Raba Léon, F-33076, Bordeaux, France. 2. Service de Neurologie, CH Pau, hôpital François Mitterrand, 4 boulevard Hauterive, 64046 Pau, France. 3. Service de Neurologie, CHU Montpellier, hôpital Gui-de-Chauliac, 80 avenue Augustin Fliche, 34295 Montpellier cedex 5, France. 4. Service de Neurologie, CHU Saint-Etienne, hôpital Nord, 42055 Saint-Etienne cedex 2, France. 5. Service de Neurologie, CHU Rennes, hôpital Pontchaillou, 2 rue Henri-Le-Guilloux, 33033 Rennes cedex, France. 6. CRC-SEP, pôle des neurosciences, et UMR 1043, CHU Toulouse et université Toulouse III, hôpital Purpan, place du Dr Joseph Baylac, TSA 40031, 31059 Toulouse cedex 9, France. 7. Service de Neurologie, CHU Poitiers, hôpital de la Milétrie, 2 rue de la Milétrie, CS90577, 86021 Poitiers cedex, France. 8. Service de Neurologie, CHU Clermont-Ferrand, hôpital Gabriel Montpied, BP 69 63003 Clermont- Ferrand cedex 11, France. 9. Service de Neurologie, CHU de Bordeaux, Place Amélie Raba Léon, F-33076, Bordeaux, France. 10. Service de Neurologie, CHU de Bordeaux, Place Amélie Raba Léon, F-33076, Bordeaux, France. Electronic address: jean-christophe.ouallet@chu-bordeaux.fr.
Abstract
BACKGROUND: Few data are available regarding patients with very late-onset inflammatory demyelinating events. (VLO-IDE). OBJECTIVES: The aim of this study was to describe the clinical, biological, and radiological characteristics and aetiological diagnosis of very late first inflammatory demyelinating events of the central nervous system. METHODS: We conducted a national descriptive retrospective multicentre study on a case series of patients aged >70 years at the time of VLO-IDE. Patients were recruited from a national call on behalf of the 'Société Francophone de la Sclérose en Plaques' (French Multiple Sclerosis Society). RESULTS: Twenty-five patients were referred (F:M sex ratio 2.1:1). The most frequent clinical impairment was a spinal cord deficit (23/25), usually severe (disability score, median EDSS 4.5 [2-9.5]). Spinal cord lesions were usually extensive, spanning at least three segments (11/25), and large brain lesions were also observed (lesions >20 mm in 6/25). The final aetiological diagnoses comprised multiple sclerosis (9/25), neuromyelitis optica spectrum disorders (7/25), neurosystemic lupus erythematosus (2/25), transverse myelitis without aetiological diagnosis (6/25) and optic neuritis (1/25). CONCLUSIONS: This study highlights a particular phenotype of first clinical inflammatory demyelinating events in predominantly female patients aged >70 years who have severe motor impairment with common longitudinal extensive myelitis and large and common very active radiological inflammatory lesions. Neuromyelitis optica spectrum disorders seem overrepresented.
BACKGROUND: Few data are available regarding patients with very late-onset inflammatory demyelinating events. (VLO-IDE). OBJECTIVES: The aim of this study was to describe the clinical, biological, and radiological characteristics and aetiological diagnosis of very late first inflammatory demyelinating events of the central nervous system. METHODS: We conducted a national descriptive retrospective multicentre study on a case series of patients aged >70 years at the time of VLO-IDE. Patients were recruited from a national call on behalf of the 'Société Francophone de la Sclérose en Plaques' (French Multiple Sclerosis Society). RESULTS: Twenty-five patients were referred (F:M sex ratio 2.1:1). The most frequent clinical impairment was a spinal cord deficit (23/25), usually severe (disability score, median EDSS 4.5 [2-9.5]). Spinal cord lesions were usually extensive, spanning at least three segments (11/25), and large brain lesions were also observed (lesions >20 mm in 6/25). The final aetiological diagnoses comprised multiple sclerosis (9/25), neuromyelitis optica spectrum disorders (7/25), neurosystemic lupus erythematosus (2/25), transverse myelitis without aetiological diagnosis (6/25) and optic neuritis (1/25). CONCLUSIONS: This study highlights a particular phenotype of first clinical inflammatory demyelinating events in predominantly female patients aged >70 years who have severe motor impairment with common longitudinal extensive myelitis and large and common very active radiological inflammatory lesions. Neuromyelitis optica spectrum disorders seem overrepresented.