Demographic, clinical, and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospital
Most of the patients with multiple sclerosis present initially as radiologically isolated syndrome followed by clinically isolated syndrome (CIS). To prevent long-term progression to multiple sclerosis, it is essential to differentiate CIS from other neurological disorders. We present two cases that...
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Wolters Kluwer Medknow Publications
2025-01-01
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| Series: | Journal of Current Research in Scientific Medicine |
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| Online Access: | https://journals.lww.com/10.4103/jcrsm.jcrsm_63_24 |
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| author | S. Ramesh Kannan Shashikala Nair Nayyar Iqbal Priya Thomas Shobana Sundaram |
| author_facet | S. Ramesh Kannan Shashikala Nair Nayyar Iqbal Priya Thomas Shobana Sundaram |
| author_sort | S. Ramesh Kannan |
| collection | DOAJ |
| description | Most of the patients with multiple sclerosis present initially as radiologically isolated syndrome followed by clinically isolated syndrome (CIS). To prevent long-term progression to multiple sclerosis, it is essential to differentiate CIS from other neurological disorders. We present two cases that were clinically diagnosed to have CIS. The patients were subjected to blood tests such as vasculitic markers, urine tests, cerebrospinal fluid (CSF) analysis, magnetic resonance imaging (MRI), and visual evoked potentials (VEP). Both the patients were middle-aged, a male and a female, and revealed evidence of demyelinating lesions of the optic nerve, subcortical, brainstem, and spinal cord in the VEP and MRI. The male patient had CSF being negative for oligoclonal bands and revealed no evidence of seromarkers such as antinuclear antibody, anti-myelin oligodendrocyte glycoprotein, and anti-aquaporin protein-4 antibodies which could explain the MRI findings. The female patient revealed demyelinating subcortical frontal and parietal lesions. She had prolonged P100 latencies suggesting optic nerve demyelination. We suggest to have a high index of suspicion about demyelinating disorders in tertiary care hospitals in the developing world, and to create awareness among the referring physicians which could help them in the early identification of patients with CIS, and prevent conversion of these patients with CIS to clinically definite multiple sclerosis with severe morbidity. |
| format | Article |
| id | doaj-art-d07babbeb8464ed2a5dbd90380670c9e |
| institution | DOAJ |
| issn | 2542-6273 2455-3069 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Current Research in Scientific Medicine |
| spelling | doaj-art-d07babbeb8464ed2a5dbd90380670c9e2025-08-20T02:42:25ZengWolters Kluwer Medknow PublicationsJournal of Current Research in Scientific Medicine2542-62732455-30692025-01-01111697110.4103/jcrsm.jcrsm_63_24Demographic, clinical, and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospitalS. Ramesh KannanShashikala NairNayyar IqbalPriya ThomasShobana SundaramMost of the patients with multiple sclerosis present initially as radiologically isolated syndrome followed by clinically isolated syndrome (CIS). To prevent long-term progression to multiple sclerosis, it is essential to differentiate CIS from other neurological disorders. We present two cases that were clinically diagnosed to have CIS. The patients were subjected to blood tests such as vasculitic markers, urine tests, cerebrospinal fluid (CSF) analysis, magnetic resonance imaging (MRI), and visual evoked potentials (VEP). Both the patients were middle-aged, a male and a female, and revealed evidence of demyelinating lesions of the optic nerve, subcortical, brainstem, and spinal cord in the VEP and MRI. The male patient had CSF being negative for oligoclonal bands and revealed no evidence of seromarkers such as antinuclear antibody, anti-myelin oligodendrocyte glycoprotein, and anti-aquaporin protein-4 antibodies which could explain the MRI findings. The female patient revealed demyelinating subcortical frontal and parietal lesions. She had prolonged P100 latencies suggesting optic nerve demyelination. We suggest to have a high index of suspicion about demyelinating disorders in tertiary care hospitals in the developing world, and to create awareness among the referring physicians which could help them in the early identification of patients with CIS, and prevent conversion of these patients with CIS to clinically definite multiple sclerosis with severe morbidity.https://journals.lww.com/10.4103/jcrsm.jcrsm_63_24clinically isolated syndromedemyelinationmultiple sclerosis |
| spellingShingle | S. Ramesh Kannan Shashikala Nair Nayyar Iqbal Priya Thomas Shobana Sundaram Demographic, clinical, and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospital Journal of Current Research in Scientific Medicine clinically isolated syndrome demyelination multiple sclerosis |
| title | Demographic, clinical, and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospital |
| title_full | Demographic, clinical, and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospital |
| title_fullStr | Demographic, clinical, and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospital |
| title_full_unstemmed | Demographic, clinical, and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospital |
| title_short | Demographic, clinical, and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospital |
| title_sort | demographic clinical and laboratory characteristics of two cases of clinically isolated syndrome in a tertiary care teaching hospital |
| topic | clinically isolated syndrome demyelination multiple sclerosis |
| url | https://journals.lww.com/10.4103/jcrsm.jcrsm_63_24 |
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