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Abstract
Background: A little is known about the characteristics of multiple sclerosis (MS) in the Arabian countries including Egypt, which represents the most populous country in the Middle East. Objective: To study the epidemiological, clinical and paraclinical characteristics of a cohort of Egyptian MS patients.Results: Clinically definite MS (CDMS) was diagnosed in 422/500 patients [relapsing remitting MS 2RRMS3 321/422 (76%); secondary progressive MS 2SPMS3 87 (20.6%); and primary progressive 2PPMS3 14 (3.4%)]; clinically isolated syndrome (CIS) in 14/500 (2.8%); MS mimics in 19/500(3.8%) [Neuromyelitis optica 2NMO3 8/19(42%);Behcet; 4 (21%); ADEM 3 (16%); vasculitis 3(16%); and nuerosarcoidosis 1(5.3%)] and radiologically isolated syndrome (RIS) in 1/500 (0.2%). The mean age of CDMS patients was 33.1±9.6 (range: 10-60 years). Females/males were 297/125 (2.37:1). The mean age at disease onset was 26.2 ±8.2 years. MS was the cause of quitting jobs in 126/422 (29.85%) patients and divorce in 16 (3.8%). Family history of MS was reported in 11 (2.6%), and of other autoimmune disorders in 17 (4%). Initial presentation was monosymptomatic in 253/422 (60%) and polysymtomatic in 169 (40%). The median disease duration was 71 months. The most common symptoms at presentation were motor, sensory, visual, and cerebello-pyramidal in 37.2%, 29.8%, 27.9 % and 7.8%, respectively. The mean annualized relapse rate (ARR) was 0.7. The initial mean EDSS was 2.7±1.7, and the Last EDSS was 3.3±2.2.Benign MS was present in 1.42% of patients, while malignant disease was observed in 4.73%. The mean duration from onset to SPMS was 7 years. Using monovariate analysis, ataxia, bladder, and infratentorial lesions on baseline brain MRI {OR (CI95%):4.87 (2.8 - 8.5), 10.3 (5.4 - 19.8) and 2.5 (1.6 - 4.1).respectively, P <0.001}were predictors for developing SPMS, and doing multivariate analysis, infratentorial lesions was the only predictor (OR = 2.2; 95% CI=1.06 {u2013} 4.6; P=0.034).