Age at onset as a determinant of presenting phenotype and initial relapse recovery in multiple sclerosis

• Published in: Multiple sclerosis 2012-01, Vol.18 (1), p.45-54
• Main Authors: Cossburn, M, Ingram, G, Hirst, C, Ben-Shlomo, Y, Pickersgill, TP, Robertson, NP
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age of Onset; Biological and medical sciences; Child; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disease Progression; Female; Humans; Male; Medical sciences; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Multiple Sclerosis, Relapsing-Remitting - epidemiology; Neurology; Phenotype; Recovery of Function; Young Adult
• ISSN: 1352-4585; 1477-0970
• DOI: 10.1177/1352458511417479

Background: Age at onset modifies prognosis in multiple sclerosis (MS) and may also exert an effect on the characteristics of disease ignition. Understanding how age influences presentation informs disease management and may allow differentiation of distinct clinical sub-groups. Objectives: To determine the nature of age-specific presentations of relapsing–remitting MS (RRMS) with respect to onset symptoms, gender ratios and index event outcomes. Methods: In a prospective, population-based sample of 1424 patients in South-East Wales we examined associations between age at onset, clinical features and outcome of the onset event, making specific comparisons between paediatric, adolescent and late-onset MS. Results: Age at onset varied significantly between sexes (Male 31.2, Female 29.3, p = 0.002), 0.7% had paediatric onset, 2.7% adolescent onset and 2.8% late-onset MS (>50 years). Optic neuritis was common in younger patients and declined after age 30. Lower limb motor, facial sensory, sexual and sphincteric symptoms rose with age independent of sex and disease course. F:M ratios were highest