1.The McDonald criteria for dissemination in space in the differential diagnosis of multiple sclerosis and neuro-Behcet’s disease
Sepideh Sefidbakht ; Meysam Babaeinejad ; Reza Jali ; Zahra Zare ; Mohammad Ali Sahraian ; Anahid Safari ; Afshin Borhani Haghighi
Neurology Asia 2014;19(1):47-52
Background: Neuro-Behcet’s disease (NBD) is similar to multiple sclerosis (MS) in multiple aspects.
This study was conducted to investigate the sensitivity, specificity, accuracy, positive and negative
predictive values for the 2005 revised McDonald MRI criteria for the diagnosis of MS and NBD.
Methods: This study enrolled 28 consecutive patients with a diagnosis of NBD and 48 patients with a
diagnosis of clinically definite MS, who were referred to the Nemazee Hospital, Shiraz University of
Medical Sciences, between March 2009 and March 2010. Brain and spinal cord magnetic resonance
imaging (MRI) were obtained. Two Radiologists, blinded to clinical diagnosis, reviewed the MRI. We
investigated the sensitivity, specificity, accuracy, and positive and negative predictive values of the
2005 revision of the McDonald criteria for dissemination in space for the diagnosis of MS and NBD.
Results: There were a total of 10 men and 38 women with a mean age of 32.76±7.5 years, with a
diagnosis of MS, and 18 men and 10 women with a mean age of 26.8±5.9 years with a diagnosis of
parenchymal NBD. The interobserver agreement for the diagnosis of MS using the 2005 revision of
the McDonald criteria for dissemination in space with the use of the Cohen kappa scores was 0.82.
The sensitivity, specificity, accuracy, and positive and negative predictive values were 80%, 61%,
71.5%, 77% and 64%, respectively.
Conclusion: The accuracy and specificity of the McDonald criteria for dissemination in space for the
differentiation of MS and NBD are not optimal.
2.The study of intermediate-term survival of the patients with cerebral venous sinus thrombosis
Afshin Borhani-Haghighi ; Soroush Ghannadi ; Anahid Safari ; Mojtaba Neydavoudi ; Maryam Poursadeghfard ; Nahid Ashjazadeh ; Etrat Hooshmandi
Neurology Asia 2020;25(4):453-457
Objective: This study aimed to investigate the intermediate survival of patients with cerebral venous
sinus thrombosis (CVST). Methods: This is a retrospective study recruiting patients with a definite
diagnosis of CVST who were referred to teaching hospitals of “Shiraz University of Medical Sciences”
from 2007 to 2017. Follow-up phone calls were conducted in March 2019 till June 2019. All-cause
mortality, mortality due to CVST, and CVST recurrence were investigated. Results: Of the total of 301
patients, 213 (70.8%) were female. Patients’ age ranged from 1 to 95 year with a mean of 39.9 year.
Intermediate follow-up (mean 46.9, 95%CI: 43.6-50.2 months) was done. Intermediate term mortality
was 12.3%, mostly from CVST, and largely occurred within the first month. Age was a significant risk
factor for survival (HR=1.056, 95%CI:1.037-1.075). The difference was not statistically significant in
males in comparison to females (HR=1.3, 95%CI:0.67-2.60, P=0.41). Patients with recurrent CVST hada higher risk of mortality (HR=9.14, 95%CI:4.70-17.89, P<0.001). There was statistically higher risk
of mortality in patients with deep vein thrombosis (DVT) (HR=8.97, 95%CI: 4.32-18.61, P<0.001).
Although the risk of death for patients using oral contraceptives (OCPs) was 16% higher, this was
not statistically significant (HR=1.16, 95%CI: 0.52-2.55, P= 0.21).
Conclusions: Intermediate-term mortality was 12.3%, and associated with older age, recurrent CVST
and DVT. The reasons for these findings need further investigation.