I optic neuriti more benign than other firt attack in multiple cleroi?

Multiple cleroi (M) often preent with iolated optic neuriti; indeed, a number of patient with iolated optic neuriti eventually develop definite M. Natural hitory tudie have uggeted that uch form of M may have a better prognoi than thoe preenting with braintem yndrome or myeliti. The goal of thi tudy wa to compare the rate of converion with definite M baed on the firt clinical preentation (iolated optic neuriti, braintem yndrome, or myeliti). The author propectively evaluated 320 patient with a clinically iolated yndrome (123 with optic neuriti, 78 with braintem yndrome, 89 with pinal cord yndrome, and 30 with other topographie) who were oberved for a median of 39 month. Patient underwent a brain MRI within 3 month of their firt attack and again 12 month later. Converion to M, determined either clinically or by MRI, wa evaluated according to topography. Baeline MRI wa normal in 49.2% of patient with optic neuriti compared with 24% of patient with braintem yndrome, 24% of patient with pinal cord yndrome, and 18.5% of patient with other yndrome. Optic neuriti patient had a lower converion to clinically definite M and a maller proportion of patient fulfilling MRI diemination in pace, time, or both. Neverthele, when only patient with abnormal cranial MRI reult at baeline were elected, no difference for clinical or MRI converion were found. The author conclude that even though optic neuriti patient have a maller rik for converion to M, it i the MRI at baeline, not the clinical preentation, which determine the ubequent rik of definite M. —Valérie Bioue