CLINICAL-STUDIES ON MULTIPLE-SCLEROSIS .1. PRESENTATION OF AN INCIDENCE MATERIAL FROM GOTHENBURG

  • 1 January 1981
    • journal article
    • research article
    • Vol. 63 (1), 6-33
Abstract
Probable and possible MS [multiple sclerosis] cases (312) with a debut during the years 1950-1964 within the city of Gothenburg were identified. This corresponds to an incidence of 5.3/100,000. The material was stratified according to diagnostic probability into 3 categories. For the final analysis, cases with the lowest diagnostic probability were omitted (about 9%). The follow-up was completed during 1977, i.e., 13-27 yr from onset. A longitudinal analysis of each case was based upon a mixed prospective-retrospective study in which the majority of the cases were examined during most of the years. The female/male ratio was 1.5-1.6. The mortality rate was higher for males due in part to an earlier progressive development of multiple sclerosis and in part to a higher trend for acquisition of other mortal diseases. Bouts, as the 1st manifestation of the disease, were more frequent in young ages than in old, and more frequent among females than in males. The average bout frequency decreased significantly with the duration of the disease as well as with the age of onset. The opposite trend was characteristic for development of a progressive course. Among symptoms at onset, those indicating lesions of long sensory and/or motor tracts (particularly the sensory) dominated. Such initial symptoms were seen in 30-40% of the younger patients and 70% of the older patients. The rest was divided between cases with optic nerve lesions (20-30% among younger, 12-15% among older patients) and brain stem lesions (approximately 25% among younger, 10-19% among older patients). The occurrence of various symptoms during the 1st 2 decades of the disease was also analyzed and the pattern of symptoms presented graphically.