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Patterns of neurologic involvement in multiple sclerosis

Neurology Service and Neuroepidemiology Research Program, Veterans Administration Medical Center
Departments of Neurology and Family and Community Medicine, Georgetown University School of Medicine, Washington, DC

Specific patterns of neurologic involvement within the 8 Functional Systems (Pyramidal, Cerebellar, Brain Stem, Sensory, Bowel & Bladder, Visual, Cerebral, Other) in a well-documented series of early MS patients have been presented in rank order of expected frequency. The first 35 and the first 86 of the 256 possible patterns comprised respectively 71% and 90% of all cases expected or observed. Patterns with increasingly higher rank orders provided increasingly greater likelihood for the diagnosis of MS. For 1 of the 4 most common patterns, the likelihood of MS was 17 times that without consideration of any pattern. In this series, the occurrence of any of the first 35 patterns was well above expectations, while patterns ranked beyond 86 were highly unlikely.

Address correspondence and reprint requests to Dr. Kurtzke, Neurology Service 127, VA Medical Center, 50 Irving Street, NW, Washington, DC 20422.

Received January 12, 1989. Accepted for publication in final form March 15, 1989.

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