Clinical Spectrum of Idiopathic Inflammatory Demyelinating Disorders in a Tertiary Care Centre in North-West India Nayak Soumya Darshan1, Sharma C.M.2, Kumawat B.L.3, Khandelwal D.3, Yadav R.4, Sahu Samir5,*, Nanda Soumya6 1Associate Professor, Department of Neurology, IMS and SUM Hospital, K8, Kalinga Nagar, Bhubaneswar, Odisha, India 2Professor, Department of Neurology, SMS Medical College, Jaipur, Rajasthan, India 3Associate Professor, Department of PSM, SMS Medical College, Jaipur, Rajasthan, India 4Professor, Department of PSM, SMS Medical College, Jaipur, Rajasthan, India 5Associate Professor, Department of Medicine, IMS; SUM Hospital, Bhubaneshwar, Odisha 6Assistant Professor, Department of Obs; Gynaecology, SCB MCH, Cuttack, Odisha *Corresponding Author, Dr. Samir Sahu, Associate Professor, Department of Medicine, IMS and SUM Hospital, Bhubaneswar. e-mail: samirsahu@1232rediffmail.com, mchsahu@gmail.com
Online published on 23 December, 2019. Abstract Background Idiopathic inflammatory demyelinating disorders of the central nervous system (IIDCDs) represent a broad spectrum of disorders whose varied clinical profile has important implications for diagnosis, management and identifying grey areas in categorization. Objective To study clinical, imaging & laboratory profile of IIDCDs pts. and categorize them into specific groups. Method Retrospective case series of 81 pts. Cases effectively categorized into 4 groups: MS, NMOSDs, CIS & ADEM and their subgroups. Cases with diagnostic difficulty later sorted out into 3 groups: Atypical, crossovers & converters. Results 32% categorized as NMOSDs, 28.4% as MS, 25.9% as CIS & 13.6% as ADEM. Monophasic (64.2%) course and polysymptomatic presentation were most common. 23.46% had optico-spinal presentation; LETM seen in 44% cases. Aquaporin-4 positivity seen in 31.25% NMOSDs. Discussion NMOSDs had higher relapse rate & disability, while longer duration of disease & frequent relapses seen in MS group. 30% CIS had abnormal brain MRI. Gray matter involvement commoner in MS & ADEM groups. Low Aquaporin-4 seropositivity in tested IIDCDs. No significant difference between seropositive & negative pts. in terms of relapses, cord length & disability. Conclusion Clinical features, course & severity play a dominant role in categorization. IIDCDs considered a spectrum because of common & overlapping clinical presentation. Top Keywords IIDCDs, MS, NMO spectrum disorders, ADEM, CIS, ON, LETM, ATM, EDSS, Aquaporin-4 antibody, annual relapse rate, monophasic, multiphasic, relapsing remitting, BON, RION, visual acuity, disability, clinical spectrum. Top |