Clinical profile of 50 adults with demyelinating diseases of central nervous system - A prospective observational study

Introduction: Demyelinating disorders of CNS are characterized by inflammation and selective destruction of central nervous system (CNS) myelin. In spite advancements in diagnostic techniques, studies on Indian adult population on the subject are very scarce. The current study is aimed to document clinicopathological profile of primary and secondary demyelinating disease of CNS in adult patients, presenting to a tertiary care teaching hospital. Materials and methods: The current study was prospective observational study of 50 patients presenting to a tertiary care teaching hospital with various symptoms suggestive of demyelinating CNS disorders and were clinically confirmed. Results: A total of 50 participants were recruited into the study. Highest proportion of subjects was below 20-year age group. The proportion of females (58%) was higher than that of males (42%). Paraplegia was the most common clinical presentation in study population, which was seen in 13 (26%) participants.. The most common level of spine involved was dorsal spine in 17 (34%) subjects and equal number of subjects had cervico dorsal spine involvement. Demyelinating Transverse myelitis was the most common type of demyelinating disorder seen in study population, which was diagnosed in 42% of the study subjects. Multiple sclerosis was present in 24% of the subjects and 22% of the subjects had ADEM. Secondary demyelination was present in 4 (8%) of the subjects and only 2 (4%) of the subjects had DEVICS. Among the causes of secondary demyelination HIV was the most common cause, present in 4% of cases. Herpes zoster and chicken pox were present in 1 (2%) of cases each in study population. Conclusions: Demyelinating disorders of the central nervous system are common among younger age group females. Primary demyelinating diseases are more common than secondary demyelinating diseases. Clinically isolated demyelination syndrome patients need regular follow up with MRI imaging in due course. Patients with more than three segmental involvement in spinal cord and those with more than three peri-callosal, peri- ventricular and posterior fossa lesions in MRI images has poor clinical recovery after treatment. MRI brain and spine provides more prognostic information than clinical assessment.