الفهرس 
Multiple Sclerosis OverviewOnly 14 pages are availabe for public view
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Abstract
Background: Little is known about the true prevalence and clinical characteristics of movement disorders in early multiple sclerosis (MS), associated clinical disability and their effect on QOL. We conducted a cross sectional study to fill this knowledge gap.
Objectives: to study the prevalence of movement disorders in early stages of multiple sclerosis, presence of other clinical disability and their effect on QOL.
Patients and method: This is a cross sectional observational study. The patients group included 250 patients with RRMS whom were recruited consecutively from the MS units of Ain Shams and Nasr institute hospitals. Each eligible patient was interviewed and examined for presence of MDs, Patients were divided into 2 groups, group A without MDs and group B showing MDs. General and neurological examination including Expanded Disability Status Scale (EDSS) score at time of interview for both groups. Magnetic resonance imaging (MRI) of brain and cervical spinal cord obtained at the time of interview with documentation of MS plaques involvement for both groups. RRMS patients with MDs (group B) are subjected to different assessment for depression by Beck Depression Inventory (BDI), cognitive assessment by Montreal Cognitive Assessment (MOCA) scale, disability and quality of life (QOL) by the Short Form 36 Health Survey Questionnaire.
Results: This study included 250 RRMS. onset of their movement disorders was 2.69 ± 2.34 years from MS diagnosis with mean EDSS 3.515 ± 1.04. Cerebellar signs are present in 97% of total number of MDs and 26% of total sample, regarding tremors, 36 patients in this study showed tremors representing 53.7% of movement disorders patients, 14.4% of total sample of RRMS patients. This study showed presence of 5 cases of restless leg syndrome 7.5% of total number of MDs. Four cases of dystonia are present in this study representing 6% of MDs patients. Patients with MDs showed presence of depressive symptoms and cognitive affection with negative impact on QOL. Tremors severity is not correlated with either cognition or depression scores where ataxia is correlated with depression score only. MRI assessment of patients with MDs showed higher lesion load and involvement of infratentorial structures especially cerebellum and its connections and brain stem.
Conclusion: Movement disorders are common to occur in patients with MS than previously known especially ataxia and tremors early in the course of the disease. Presence of MDs is related to high lesion load and strategic location of these lesions. Special assessment of MDs as independent cause of disability with concomitant depression and CI especially early in the disease course should be taken in consideration due to their negative impact on QOL.