Risk of MS after single case of optic neuritis?

[Exedoc]

I am a medical student and I am finding it hard to figure this out, so I can imagine how stressful it must be for patients!

 

A friend of mine suffered a severe case of unilateral optic neuritis about 2 years ago. She is black, female ofc, and she was 17/18 at the time.As far as I know she had no other neuro symptoms before or since.

 

All tests at the time came back normal, she lives in the US so I imagine they did the full shebang of tests too. No lesions on MRI anyway, no family history of MS.

 

Basically.. what is her risk?! There are so many studies out there all saying different things! A lot of them are of such small patient groups to.. like 100 patients sometimes! And it doesn't often stratify your risk according to your demographic and symptoms, and for example, ON in "children and over 40s" is supposed to be much lower risk than the 2-30 age group but where does 17/18 fit into that?

 

So I was wondering if someone here knows what sort of risk she has, are we talking "she pretty much has MS, just a matter of time" or are we talking "very unlikely but a slightly higher chance than someone who hadn't had ON"?

 

1%? 10%? 75%? I have seen them all!

[Hezza]

Hi Exedoc

aaarrrgggghhhh - I just wrote you a long reply and then lost it . I'll try to recycle it

 

I suspect the reason you can't find one simple risk ratio is because noone can give an exact ratio to be honest. Just like MS I think it varies from individual to individual except on an individual basis.

 

I can't give you a medical opinion but can share my own personal experience with you.

 

I do have a little knowledge of your friend's situation as my first major symptom was Optic Neuritis ( ON). When it first occurred I was 29 and hadn't had any other major symptoms. On my 1st visit to my Neuro he suggested that my chances of going on to develop MS, before any other tests were carried out, was 50/50. This ratio was based on the neuro examination that he performed, my medical history and my family history - aunt on my Dad's side and cousin on my Mum's with MS.

 

The neuro ordered a brain MRI & Visual Evoked Potentials (VEPs). The MRI showed damage to my optic nerve and a teeny tiny lesion somewhere. The VEP was, unsurprisingly given I could hardly see out of my left eye, abnormal. These results weren't enough for a diagnosis ( Dx) but I had had other symptoms in my foot in the meantime. The Neuro offered me a spinal MRI and was clear that if I had it and there was a lesion then I had MS, if not we'd discuss whether I was at 50/50 risk or higher now.

 

That MRI confirmed my Dx and, if I'm honest with a 50% chance, I was glad because I would rather have MS and get on with it than wait and wonder.

 

So...I'm afraid I haven't been able to offer much help. Each case truly is different.

 

You might find the MS Trust website useful for more info. This article might help to start: http://www.mstrust.org.uk/atoz/cis.jsp

Edited 2 Mar 2011, 10:15 am by Hezza
Fixing typos!