Ik ga even terug naar de discussie over CIS/CDMS - ik lees dit op Facebook:
Citaat:
not all CIS patients will covert to CDMS (22%, Cohen & Ruddick 2007), I think that the true CDMS CCSVI results are skewed significantly by lumping the 2 groups
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Heb de betreffende studie nog niet kunnen vinden maar als dat waar is dan zou 'slechts'22% van de CIS personen uiteindelijk MS ontwikkelen. verder nog een studie gevonden waaruit blijkt dat bij 90% van de mensen die CDMS ontwikkelen vanuit CIS er bij de ontdekking van CIS al afwijkingen waren te zien op de MRI.
Citaat:
However, the question remains how to predict that a patient with CIS will develop CDMS? Several prospective studies addressed this issue using MRI as a surrogate marker in patients with CIS who already showed evidence of occult disease dissemination by the presence of asymptomatic white-matter lesions.[37-42] The majority of these patients will go on to develop CDMS. In the Optic Neuritis Treatment Trial (ONTT) the number of brain lesions present in patients with monosymptomatic optic neuritis was a strong predictor of the likelihood for developing CDMS (Class I evidence).[43] A recently published 14-year prospective study on the use of MRI to predict the risk of developing MS in patients with CIS revealed that almost 90% of patients with abnormal baseline MRI developed CDMS during the follow-up period.[4] Interestingly, the conversion rates to definite MS did not depend on the number of lesions present on brain MRI at baseline.
Thus, multiple demyelinating lesions as seen on MRI at the time of CIS support the contention that the clinical presentation does not reflect the first pathological manifestation. Prospective MRI studies have shown[44]:
•Lesional dissemination on brain MRI in a patient with CIS strongly predicts future conversion to CDMS (Class I).[4,34,35]
•Gadolinium-enhanced lesions at baseline strongly predicts future conversion to CDMS (Class I).[45]
•The application of the new McDonald criteria more than doubles the rate of the diagnosis of MS within a year of presentation with a CIS (Class I).[41]
•In patients with a classical syndrome of inflammatory demyelination and an abnormal baseline MRI, the possibility of an alternative diagnosis is negligible (Class I).[4,34,35
http://www.medscape.com/viewarticle/459967_3