The aetiology of acute neurological decline in multiple sclerosis: Experience from an openaccess clinic

Аннотация

Multiple sclerosis (MS) relapses contribute to disability and influence treatment decisions.Many centres now provide open access to specialist services for patients with new symptoms. However,there is scarce literature on the spectrum of presentations encountered in this setting.Objective: The objective of this paper is to characterise presentations to an open, rapid-access MS relapseclinic and the impact on disease management. Methods: A retrospective review of outpatient episodes over a three-year period was conducted. Demographic and service data, symptoms, disability, diagnosis and management were recorded according to astandardised proforma.Results: A total of 371 attendances were analysed. A new MS relapse was diagnosed in 216 (58%)episodes, of which 56 (26%) patients had an additional diagnosis which had also contributed to theirpresentation. Of 266 reports of non-relapse-related symptoms, 73 were unrelated to MS. Treatment interventions were made in almost all relapsing patients and in 70% of patients presenting with acute, nonrelapse-related symptoms of MS. Changes to disease-modifying therapies were considered in 28% ofconsultations