scholarly journals Radiologically isolated syndrome is antiquated amidst evolving McDonald criteria for multiple sclerosis

CNS Spectrums ◽  
2019 ◽  
pp. 1-3
Author(s):  
Jagannadha Avasarala ◽  
Fawad Yousuf
Keyword(s):  
Multiple Sclerosis ◽  
Optic Nerve ◽  
Diagnostic Criteria ◽  
Mcdonald Criteria ◽  
Radiologically Isolated Syndrome ◽  
Nerve Involvement ◽  
Appropriate Treatment ◽  
Modern Era ◽  
Optic Nerve Involvement

The diagnosis of radiologically isolated syndrome (RIS) is untenable in the modern era as new diagnostic criteria for multiple sclerosis (MS) continue to evolve. Even without optic nerve involvement, the shift in the diagnostic criteria for MS forces clinicians to make a diagnosis at the earliest possible time and appropriate treatment initiated. In this analysis, we revisit the original RIS criteria as published and conclude that RIS as a diagnostic entity is obsolete.

scholarly journals Inclusion of optic nerve involvement in dissemination in space criteria for multiple sclerosis

Neurology ◽  
2018 ◽  
Vol 91 (12) ◽  
pp. e1130-e1134 ◽  
Author(s):  
Wallace J. Brownlee ◽  
Katherine A. Miszkiel ◽  
Carmen Tur ◽  
Frederik Barkhof ◽  
David H. Miller ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Optic Nerve ◽  
Diagnostic Criteria ◽  
Class Iii ◽  
Mri Brain ◽  
Nerve Involvement ◽  
Overall Performance ◽  
Criteria For Diagnosis ◽  
Time Of Presentation ◽  
Optic Nerve Involvement

ObjectiveTo investigate the effect of including optic nerve involvement in dissemination in space (DIS) criteria for diagnosis of multiple sclerosis (MS) in patients with clinically isolated syndrome (CIS).MethodsWe studied 160 patients with CIS: 129 with optic neuritis (ON) and 31 with non-ON CIS. MRI brain/spinal cord was done at the time of presentation and a follow-up MRI brain after 3–12 months. We evaluated optic nerve involvement clinically or with visual evoked potentials (VEPs, n = 42). We investigated the performance of the McDonald 2017 DIS criteria and modified DIS criteria including optic nerve involvement for development of clinically definite MS after ∼15 years.ResultsIn the ON group, including symptomatic optic nerve involvement identified an additional 15 patients with DIS. The modified DIS criteria that included optic nerve involvement were more sensitive (95% vs 83%) and more accurate (81% vs 78%) than the McDonald 2017 DIS criteria, but less specific (57% vs 68%). In combination with dissemination in time criteria, the modified DIS criteria remained more sensitive (83% vs 74%) and accurate (81% vs 75%), and the specificity was the same (77%). Including asymptomatic optic nerve involvement in DIS the non-ON group did not identify any additional patients and the performance of the McDonald 2017 criteria and the modified criteria was the same.ConclusionThe inclusion of symptomatic optic nerve involvement in DIS in patients with ON improved the overall performance of MS diagnostic criteria. Including asymptomatic optic nerve involvement in DIS in patients with a non-ON CIS may be of limited value.Classification of evidenceThis study provides Class III evidence that for patients with suspected MS, inclusion of symptomatic optic nerve involvement in DIS criteria improves the overall performance of diagnostic criteria for MS.

Central vein sign and other radiographic features distinguishing myelin oligodendrocyte glycoprotein antibody disease from multiple sclerosis and aquaporin-4 antibody-positive neuromyelitis optica

2021 ◽  
pp. 135245852110070
Author(s):  
John R Ciotti ◽  
Noah S Eby ◽  
Matthew R Brier ◽  
Gregory F Wu ◽  
Salim Chahin ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Optic Nerve ◽  
Neuromyelitis Optica ◽  
Myelin Oligodendrocyte Glycoprotein ◽  
Aquaporin 4 ◽  
Central Vein ◽  
Nerve Involvement ◽  
Fluid Attenuated Inversion Recovery ◽  
Optic Nerve Involvement

Background: Myelin oligodendrocyte glycoprotein antibody disease (MOGAD) can radiographically mimic multiple sclerosis (MS) and aquaporin-4 (AQP4) antibody-positive neuromyelitis optica spectrum disorder (NMOSD). Central vein sign (CVS) prevalence has not yet been well-established in MOGAD. Objective: Characterize the magnetic resonance imaging (MRI) appearance and CVS prevalence of MOGAD patients in comparison to matched cohorts of MS and AQP4+ NMOSD. Methods: Clinical MRIs from 26 MOGAD patients were compared to matched cohorts of MS and AQP4+ NMOSD. Brain MRIs were assessed for involvement within predefined regions of interest. CVS was assessed by overlaying fluid-attenuated inversion recovery (FLAIR) and susceptibility-weighted sequences. Topographic analyses were performed on spinal cord and orbital MRIs when available. Results: MOGAD patients had fewer brain lesions and average CVS+ rate of 12.1%, compared to 44.4% in MS patients ( p = 0.0008). MOGAD spinal cord and optic nerve involvement was lengthier than MS (5.8 vs 1.0 vertebral segments, p = 0.020; 3.0 vs 0.5 cm, p < 0.0001). MOGAD patients tended to have bilateral/anterior optic nerve pathology with perineural contrast enhancement, contrasting with posterior optic nerve involvement in NMOSD. Conclusion: CVS+ rate and longer segments of involvement in the spinal cord and optic nerve can differentiate MOGAD from MS, but do not discriminate as well between MOGAD and AQP4+ NMOSD.

Optic nerve double inversion recovery hypersignal in patients with clinically isolated syndrome is associated with asymptomatic gadolinium-enhanced lesion

2018 ◽  
Vol 25 (14) ◽  
pp. 1888-1895 ◽  
Author(s):  
Frédéric London ◽  
Hélène Zéphir ◽  
Nawal Hadhoum ◽  
Julien Lannoy ◽  
Patrick Vermersch ◽  
...  
Keyword(s):  
Optic Nerve ◽  
Clinical Stage ◽  
Clinically Isolated Syndrome ◽  
Inversion Recovery ◽  
Activity Level ◽  
Double Inversion Recovery ◽  
Optic Nerves ◽  
Mcdonald Criteria ◽  
Nerve Involvement ◽  
Optic Nerve Involvement

Background: Optic nerve involvement is not considered in dissemination in space (DIS) or time (DIT) of multiple sclerosis (MS) lesions. Objectives: To evaluate frequency of optic nerve involvement using three-dimensional (3D)-double inversion recovery (DIR) sequence in clinically isolated syndrome (CIS) and to measure its relationship with DIS and DIT (2010 and 2017 McDonald criteria). Methods: From November 2013 to August 2016, 57 CIS patients underwent 3T-magnetic resonance imaging (3T-MRI) including 3D-DIR sequence and optical coherence tomography (OCT) at 3 months after CIS. We assessed signal abnormalities of the optic nerves on DIR sequence and collected data for DIS and DIT criteria according to 2010 and 2017 McDonald criteria. Results: Among the 57 recruited patients, the presence of ⩾1 DIR hypersignal in optic nerve was observed in 36 (63%; 48 optic nerves) including asymptomatic hypersignal in 22 (38.5%; 25 optic nerves). Optic nerve involvement was significantly associated with DIT ( p = 0.006) and MS according to 2010 criteria ( p = 0.01) but was not significantly associated with presence of DIS criteria according to 2010 and 2017 McDonald criteria. We identified a significant ( p < 0.001) temporal peripapillary retinal nerve fiber layer thinning on eyes with optic nerve involvement versus healthy controls. Conclusions: Optic nerve involvement is very frequent at the earliest clinical stage of MS. It is associated with the presence of asymptomatic gadolinium-enhancement and retinal axonal loss and may reflect the inflammatory disease activity level.

Isolated optic nerve involvement in chronic myeloid leukemia

1992 ◽  
Vol 16 (4) ◽  
pp. 411-413 ◽  
Author(s):  
Ciro Costagliola ◽  
Mario Rinaldi ◽  
Luigi Cotticelli ◽  
Sandro Sbordone ◽  
Giacomo Nastri
Keyword(s):  
Optic Nerve ◽  
Chronic Myeloid Leukemia ◽  
Myeloid Leukemia ◽  
Nerve Involvement ◽  
Optic Nerve Involvement
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