Risk Factors and Clinical Profiles of Multiple Sclerosis with Extent of Disability: A Study from Tertiary Care Center

Background: Multiple sclerosis (MS) is a neurological disorder involving central nerves system. MS can affect both genders, more commonly women and younger adults. MS is associated with various risk factors and can lead to significant disability and poor quality of life. Aim: The present study is to investigate, the clinical profile, risk factors and assess their correlation with disability using Expanded Disability Status Scale (EDSS). Methods: This prospective observational study recruited 102 patients with MS at department of Neurology, Yashoda hospital, Hyderabad, India. All patients met the McDonald’s 2010 criteria for MS. Risk factor evaluation was done. EDSS was done for all patients. Analysis was performed after dichotomizing patients based on EDSS (≤ 3.0 and ≥ 3.5 EDSS). Results: Out of 102 patients, women were 60 (58.2%), mean age was 47.2 ± 13.4 years. On clinical symptoms, optic neuritis was seen in 70 (68.6%), sensory involvement in 46 (45%) and bladder symptoms in 33 (32.3%). Associated peripheral nerve involvement was seen in 40 (39.2%). Hypertension was noted in 13 (12.7%), diabetic mellitus in 18 (17.6%), smoking in 38 (37.2%), alcoholism in 35 (34.3%), obesity in 28 (27.4%), 25-hydroxyvitamin D deficiency in 57 (55.8%), and non-vegetarian diet in 76 (74.6%) patients. In MS subtypes, 68 (66.6%) had RRMS, 5 (4.9%) had SPMS and 29 (28.4%) CIS. We compared the risk factors between patients with mild disability (> 3.0 EDSS) and severe disability (> 3.5 EDSS). Women (p=0.002), age>40 years (p=0.005) smoking (p=0.01), alcoholism (p=0.01), obesity (p=0.002), 25-hydroxyvitamin D deficiency (p=0.001) and vegetarian diet (p<0.0001) were significantly associated with severe disability. Conclusion: In our study, we established female gender, age>40 years, smoking, alcoholism, obesity, 25-hydroxyvitamin D deficiency and vegetarian diet to be associated with severe disability in patients with MS.