Türk Nöroloji Dergisi (Apr 2004)
The Importance of Cerebellar Involvement in Identifying the Prognosis in Patients with Progressive Multiple Sclerosis
Abstract
Background: Cerebellar involvement is one of the bad prognostic factors in patients with multiple sclerosis (MS). Objective: In this study the importance of demographic and clinical features as well as localization of lesions seen in the magnetic resonance imaging (MRI), which possibly have a role in the occurence of severe cerebellar symptoms were investigated in patients with secondary and primary progressive MS (SPMS, PPMS). Material and Method: Thirty-two MS patients (29 SPMS, 3 PPMS) with high cerebellar functional system (FS) score (3-5) were compared with 20 MS patients (18 SPMS, 2 PPMS) with low cerebellar FS (0-2). Results: The number of relapses that have occurred before transformation to secondary progressive form was higher in patients with severe cerebellar involvement than patients with moderate cerebellar involvement. Furthermore, not only cerebellar FS scores but also other FS scores were higher in the group of patients with severe cerebellar signs. The number of patients who have MRI lesions localised to mesencephalon, cerebellum and superior pedincule was higher in patients with severe cerebellar involvement (p<0.05) and among these localizations cerebellum reached the highest statistical significance (p<0.001). Conclusions: These results suggested that the evaluation of lesion load at mesencephalon, cerebellum and their connections with MRI could provide additional data in defining the prognosis of MS.
