First clinical inflammatory demyelinating events of the central nervous system in a population aged over 70 years: A multicentre study.
BACKGROUND
Few data are available regarding patients with very late-onset inflammatory demyelinating events. (VLO-IDE).


OBJECTIVES
The aim of this study was to describe the clinical, biological, and radiological characteristics and aetiological diagnosis of very late first inflammatory demyelinating events of the central nervous system.


METHODS
We conducted a national descriptive retrospective multicentre study on a case series of patients aged >70 years at the time of VLO-IDE. Patients were recruited from a national call on behalf of the 'Société Francophone de la Sclérose en Plaques' (French Multiple Sclerosis Society).


RESULTS
Twenty-five patients were referred (F:M sex ratio 2.1:1). The most frequent clinical impairment was a spinal cord deficit (23/25), usually severe (disability score, median EDSS 4.5 [2-9.5]). Spinal cord lesions were usually extensive, spanning at least three segments (11/25), and large brain lesions were also observed (lesions >20 mm in 6/25). The final aetiological diagnoses comprised multiple sclerosis (9/25), neuromyelitis optica spectrum disorders (7/25), neurosystemic lupus erythematosus (2/25), transverse myelitis without aetiological diagnosis (6/25) and optic neuritis (1/25).


CONCLUSIONS
This study highlights a particular phenotype of first clinical inflammatory demyelinating events in predominantly female patients aged >70 years who have severe motor impairment with common longitudinal extensive myelitis and large and common very active radiological inflammatory lesions. Neuromyelitis optica spectrum disorders seem overrepresented.
['Lavandier|Noëlle|N|', 'Bonnan|Mickaël|M|', 'Carra-Dallière|Clarisse|C|', 'Charif|Mahmoud|M|', 'Labauge|Pierre|P|', 'Camdessanche|Jean-Philippe|JP|', 'Edan|Gilles|G|', 'Naudin|Aurore|A|', 'Brassat|David|D|', 'Ciron|Jonathan|J|', 'Clavelou|Pierre|P|', 'Dulau|Cécile|C|', 'Moroso|Amandine|A|', 'Brochet|Bruno|B|', 'Ouallet|Jean-Christophe|JC|', '|||']
D017668:Age of Onset D000368:Aged D000369:Aged, 80 and over D001921:Brain D002493:Central Nervous System Diseases D003711:Demyelinating Diseases D005260:Female D005500:Follow-Up Studies D006801:Humans D007249:Inflammation D008297:Male D012189:Retrospective Studies D013116:Spinal Cord
Ageing Multiple sclerosis Neuromyelitis optica Transverse myelitis Optic neuritis Late onset