Clinical Features of Patients With Familiar Multiple Sclerosis in Lithuania

Background: Most multiple sclerosis (MS) cases are sporadic, however about 20 percent are hereditary [2]. It is still unclear whether heredity affects the progression and severity of the disease. The aim of this study is to assess the effect of heredity on the development of multiple sclerosis and on the course of disease by analyzing the results of disability, severity scales and clinical studies, and comparing them with sporadic cases. Methods. Our study included 104 patients with MS. The study group was comprised of 38 patients with family history of MS; the control group consisted of 66 patients with no family history. The survey included questions about demographic and clinical characteristics. Diagnostic results were evaluated retrospectively from medical records. Disability assessment was made according to EDSS. MSSS score was calculated using conversion table. Results. Patients with a family history tend to have slower onset of the disease, while control group is more likely to have an acute onset (p <0.001). Study group more often complained of symptoms related to pyramidal (74 % vs. 50 %) and brainstem (68 % vs. 20 %), cognitive dysfunction (47 % vs. 20 %), headache (37 % vs. 9 %), back pain (32 % vs. 9 %) than those in control group, p <0.05. EDSS and MSSS scores were higher in familiar cases (p <0.05). The number of exacerbations per year was also higher in study group (1.4 vs. 0.8; p <0.05). Patients with a family history have a higher incidence of MRI changes in brainstem (74% vs. 30%) and cerebellum (58% vs. 30%) than the control group (p <0.01). Conclusions. Patients with a family history tend to have slower onset of the disease, while control group is more likely to have an acute onset. Patients with a family history of MS more often complained of brainstem and cortical dysfunction, and pain in head or back. Both EDSS and MSSS scores were higher in familiar cases. They also have a higher number of exacerbations per year. Patients with a family history have a higher incidence of MRI changes in brainstem and cerebellum.