Clinical and Demographical Features of The Patients with Multiple Sclerosis Followed in The Upper Part Section of Firat

Yıl 2011, Cilt: 16 Sayı: 2, 84 - 90, 01.04.2011

Serpil Bulut Hakverdi Kılıç Caner Feyzi Demir

Öz

Objective: Multiple sclerosis is the most common cause of neurological disability in young adults after trauma. In this study we analyzed the demographic and clinical features of MS patients in the upper part section of Fırat river between 1997 and 2007. We also evaluated the expanded disability status scale (EDSS) score. Material and Methods: Among 297 patients, 121 patients those known to have definite MS according to 2005 revisions to the McDonald's criteria and those followed up by Neurology Department were included in the study. Demographic data and case-related information were recorded from hospital database. Results: Among these patients 30.6% were males and 69.4% were females. The mean age at onset was 30.41 ±9.4 years. Mean duration of disease was 8.00 ±5.9 years. The presenting symptoms were motor in 32%, sensory in 24%, optic neuritis in 15.7%, brainstem- cerebellar finding 21.5% and other findings in 6.6%. Disease course was defined as relapsing-remitting course in 54.5% of patients, secondary progressive in 28%, primary progressive in 12.3% and benign course in 4.9% of patients. We were recorded familial multiple sclerosis frequency in 11.5%. Conclusion: In this study our results were compared with other studies reported in the literature. Despite the inadequate number of patients enrolled, because these data's are valuable, since this is the first epidemiologic data's of MS patients localized in our region. We hope that our data's will be a guide for further researches.

Anahtar Kelimeler

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Yukarı Fırat Bölgesinde Multipl Skleroz Tanısı İle İzlenen Hastaların Klinik ve Demografik Özellikleri

Öz

Amaç: Multipl skleroz genç yetişkinlerde travmadan sonra özürlülüğe sebep olan hastalıkların başında gelir. Bu çalışmada 1997-2007 yılları arasında yukarı Fırat bölgesinde MS'lu hastaların demografik ve klinik özelliklerini inceledik. Ayrıca her hasta için nörolojik takip amaçlı EDSS (expanded disability status scale) skorlamasını değerlendirdik. Gereç ve Yöntem: Nöroloji Bölümünce takip edilen 297 multipl skleroz hastasından, gözden geçirilmiş McDonald tanı kriterlerine göre kesin MS tanısı almış 121 hasta çalışmaya alındı. Demografik veriler ve vaka bilgileri hastane veri tabanından alındı. Bulgular: Hastaların %30.6'sı erkek ve %69.4' ü kadındı. Ortalama başlangıç yaşı 30.41 ± 9.4 idi. Ortalama hastalık süresi 8.00 ± 5.9 yıldı. Başlangıç semptomları hastaların %32'sinde motor, %24'ünde sensoriyel, %15.7'sinde optik nörit, %21.5'inde beyinsapı-serebeller bulgular ve %6.6'sında diğer bulgular izlendi. Hastalığın seyri %54.5 RRMS, %28 SPMS, %12.3 PPMS ve %4.9 BMS olarak tanımlandı. Ailesel MS sıklığı %11.5 olarak kaydedildi. Sonuç: Bu çalışmada elde ettiğimiz bulgular literatürde bildirilen diğer çalışma bulgularıyla karşılaştırılmıştır. Çalışmadaki hasta sayısı yeterli olmamakla birlikte, bölgemizdeki MS hastalarına ait ilk epidemiyolojik veriler olması nedeniyle değerlidir. Verilerimizin başka çalışmalar için yol gösterici olacağını umuyoruz.

Anahtar Kelimeler

Multipl skleroz, genişletilmiş özürlülük durum skalası (EDSS), epidemiyoloji

Kaynakça

• Eraksoy M, Akman Demir G. Merkez sinir sisteminin miyelin hastalıkları. A. Emre ÖGE (editör). İstanbul Tıp Fakültesi Te- mel ve Klinik Bilimler Ders Kitapları. Nöroloji. İstanbul: No- bel Kitabevi, 2004; 505-535.
• Poser CM, Brinar VV. Multipl sclerosis 2001. Clin Neurol Neurosurg 2002; 104: 165-167.
• Modrego JP, Pina MA. Trends in prevalence and incidence of multipl sclerosis in Bajo Aragon, Spain. J Neurol Sci 2003; 216: 89-93.
• Itoh T, Aizawa H, Hashimoto K, et al. Prevalance of multipl sclerosis in Asahikawa, a city in northern Japan. J Neurol Sci 2004; 217: 7 -115.
• Houzen H, Niino M, Kikuchi S, Fakazawa T, Nogoshi S, Matsumoto H, et al. The prevalence and clinical characteristics of MS in northern Japan. J Neurol Sci 2004; 211: 49-53.
• McDonnell GV, Hawkins SA. Multipl sclerosis in northern Ireland: a historical and global perspective. Ulster Med J 2000; 69: 97-105.
• Karni A, Kahana E, Zilber N, Abramsky O, Alter M, Karussis D. The frequency of multipl sclerosis in jewish and arab population in greater jerusalem. Neuroepidemiology 2003; 22: 82-6.
• Totaro R, Marini C, Cialfi A, Giunta M, Carolei A. Prevalence of multipl sclerosis in the L’Aquila district, cental Italy. J Neurol Neurosurg Psychiatry 2000; 68: 349-352.
• Benito-Leon J, Martin E, Vela L, et al. Multipl sclerosis in Mostoles, central Spain. Acta Neurol Scand 1998; 98: 238- 242.
• Bencsik K, Rajda C, Fuvesi J et al. The prevalence of multipl sclerosis, distribution of clinical forms of the disease and functional status of patients in Csongrad County Hungsry. Eur Neurol 2001; 46: 206-209.
• Piperridou HN, Heliopoulos IN, Maltezos ES, Milonas IA. Epidemiological data of multipl scleosis in the province of Evros, Greece. Eur Neurol 2003; 49: 8-12.
• Radhakrishnan K, Ashok PP, Sridharan R, Mousa ME. Prevalence and pattern of multipl sclerosis in Benghazi, nortth-eastern Libya. J Neuro Sci 1985; 70: 39-46.
• Birgili Ö. Trakya Üniversitesi Tıp Fakültesi Nöroloji Anabilim dalında multipl skleroz tanısı ile izlenen hastaların epidemiyo- lojik ve demografik özellikleri. Uzmanlık tezi, Edirne: Trakya Üniversitesi Tıp Fakültesi, Nöroloji bölümü 2004.
• Tola MA, Yugueros MI, Fernandez-Buey N, Fernandez- Herranz R. Prevalance of multipl sclerosis in Valladolid, northern Spain. J Neurol 1999; 246: 170-174.
• Bufill E, Blesa R, Galan I, Dean G. Prevalence of multipl sclerosis in the region of Osona, Catalonia northern Spain. J Neurol Neurosurg Psychiatry 1995; 58: 577-581.
• Kantarci O, Siva A, Eraksoy M, et al. Survival Turkish multipl sclerosis study group (TUMSSG). Neurology 1998; 51: 765- 772.
• Ford HL, Gerry E, Johnson M, Williams R. A prospective study of the incidence, prevalance and mortality of multipl sclerosis in Leeds. J Neurol 2002; 249: 260-265.
• Rodriguez M, Siva A, Ward J, Stolp-Smith K, O’Brien P, Kurland L. Impairment, disability, and handicap in multipl sclerosis: a population-based study in Olmsted Country, Minnesota. Neurology 1994; 44: 28-33.
• Yüceyar N, Arıcı Ş, Kısabay A, Sağduyu Kocaman A. Naturel history and early prognostic clinical factors in multipl sclerosis. J Neurological 2007; 24: 135-143.
• Runmarker B, Anderson O. Prognostic factors in a MS incidence cohort with 25 years of follow up. Brain 1993; 116: 117-134.
• Weinshenker BG, Bass B, Rice GP, et al. The natural history of multipl sclerosis: a geographically based study. I. Clinical course and disability. Brain 1989; 112: 133–146.
• Tremlett H, Yinshan Zhao, Devonshire V. Naturel history of secondary- progresive multipl sclerosis. Mult Scler 2008; 14: 314-324.
• Pugliatti M, Sotgiu S, Solinas G, et al. Multipl sclerosis epidemiology in Sardinia: evidence for a true increasing risk. Acta Neurol Scand 2001; 103: 20-26.
• McAlpine D, Lumsden CE, Acheson ED. MS. A Reappraisal, 2nd edn, Churchill Livigstone, Edinburg, 1972; pp: 3-80.
• Sadovnic AD, Ebers GC, Ward RH. Multile sclerosis: Updated risks for relatives. J Med Genet 1988; 29: 533.
• Fricska-Nagy Z, Bencsik K, Rajda C, et al. Epidemiology of familial multipl sclerosis in Hungary. Mult Scler 2007; 13: 260-261.
• Casquero P, Villoslada P, Montalban X, Torrent M. Frequency of multipl sclerosis in Menorca, Balearic islands, Spain. Neuroepidemiology 2001; 20: 129-33.
• Gönderilme Tarihi: 23.10.2010