PATTERN OF PRESENTATION OF MULTIPLE-SCLEROSIS IN SAUDI-ARABIA - ANALYSIS BASED ON CLINICAL AND PARACLINICAL FEATURES

We studied 89 MS patients comprising 38 males and 51 females seen over a 10-year period. The hospital frequency was 25/100,000 patients. The diagnosis was mainly clinical and was supported by neuroimaging, cere brospinal fluid analysis and neurophysiological tests. Sixty-five pati ents (73%) were Saudis and the peak age of onset was in the third deca de. Fifty-two patients (58.4%) had clinically definite MS, 17(19.1%) h ad laboratory-supported definite MS, 15 (16.9%) were clinically probab le MS cases and the remaining 5 (5.6%) had laboratory-supported probab le MS. The mean age at onset of Saudi patients (25.9 years) was lower than that of the non-Saudis (29.4 years; p < 0.001). Involvement of th e pyramidal system was the commonest mode of presentation. The clinica l course was relapsing-remitting in 60.7%, progressive-relapsing in 20 .2% and primary progressive in 19.1%. The number of systems involved w as significantly associated with the duration of disease (p < 0.001). The demographic features and the variability of clinical presentation of Saudi MS patients is similar to the results from neighbouring count ries. Combination of clinical features and paraclinical tests is essen tial for accurate determination of extent of dissemination and for unm asking clinically silent lesions.