Pakistan Journal of Medical Sciences

Published by : PROFESSIONAL MEDICAL PUBLICATIONS

ISSN 1681-715X

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ORIGINAL ARTICLE

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Volume 24

April - June 2008 (Part-I)

Number  2


 

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Clinical spectrum of multiple sclerosis at a
Tertiary Care Hospital in Pakistan

Hoori Shahwar1, Syed Wasim Akhter2, Shaukat Ali3

ABSTRACT

Objective: To assess the clinical presentation of multiple sclerosis.

Methodology: This hospital based observational study was carried out from November 2004 to June 2005 at the Department of Neurology Jinnah Post Graduate Medical Center Karachi. Patients of multiple sclerosis (MS) diagnosed on Poserís criteria were observed on the basis of age at the onset, gender, family history, symptoms and signs, clinical course, magnetic resonance imaging, visual evoked potentials, cerebrospinal fluid and oligoclonal bands.

Results: Out of 20 patients there were 13 females with M:F ratio of 1:2. Mean age at presentation was 25.8 years. Family history was negative. Clinical presentation included pyramidal weakness (75%), visual defect (70%), sphincter disturbances (60%), sensory impairment (35%), cerebellar signs (30%) and paroxysmal spasm (25%). The clinical course of multiple sclerosis included Relapsing and Remitting RRMS (55%), Secondary Progressive SPMS (20%), Primary Progressive PPMS (15%) and Progressive Relapsing PRMS (10%). Optico-spinal type was seen in 55%. Magnetic resonance imaging of brain was positive in 75% and of cervico-dorsal in 100%. Visual evoked potential was abnormal in 85% and oligoclonal bands were present in 5%.

Conclusions: Multiple Sclerosis (MS) is not uncommon in Pakistan. The study revealed that young females were affected more compared with men with a ratio of 2:1 and mean age of onset was 25.8 years. Clinical type is in agreement with Asian variety of disease with high occurrence of optico-spinal presentation and low yield of oligoclonal band.

KEY WORDS: Multiple Sclerosis, Optico-Spinal MS, Oligoclonal Bands.

Pak J Med Sci    April - June 2008 (Part-I)    Vol. 24 No. 2    221-226


1. Hoori Shahwar,
Department of Neurology,
Jinnah Post graduate Medical Center Karachi.
2. Syed Wasim Akhter,
Department of Neurology,
Baqai Medical University Karachi. 
3. Shaukat Ali,
Department of Neurology,
Jinnah Postgraduate Medical Center Karachi.
Baqai Medical University Karachi,
Karachi - Pakistan.

Correspondence: 

Dr. Hoori Shahwar,
Department of Neurology,
Jinnah Postgraduate Medical Center,
Karachi, Pakistan
E-Mail: drhoori@gmail.com 

* Received for Publication: September 26, 2007
* Revision Received: January 24, 2008
* 2nd Revision Received: February 8, 2008
* Final Revision Accepted: February 10, 2008



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