@article{2999456,
    title = "The onset of multiple sclerosis in Greece: A single-center study of 1,034 consecutive patients",
    author = "Koutsis, G. and Evangelopoulos, M.E. and Andreadou, E. and Mandellos, D. and Karachalios, G. and Potagas, C. and Karantoni, E. and Karouli, M. and Chrysovitsanou, C. and Vassilopoulos, D. and Sfagos, C.",
    journal = "European Neurological Review",
    year = "2010",
    volume = "63",
    number = "6",
    pages = "350-356",
    doi = "10.1159/000313457",
    keywords = "adolescent;  adult;  article;  brain dysfunction;  brain stem dysfunction;  child;  disease course;  female;  Greece;  human;  infant;  major clinical study;  male;  multiple sclerosis;  newborn;  onset age;  optic neuritis;  priority journal;  prognosis;  scoring system;  sex difference;  survival rate;  Kaplan Meier method;  multiple sclerosis;  nonparametric test;  onset age;  pathophysiology;  retrospective study;  severity of illness index;  young adult, Adult;  Age of Onset;  Female;  Greece;  Humans;  Kaplan-Meiers Estimate;  Male;  Multiple Sclerosis;  Retrospective Studies;  Severity of Illness Index;  Statistics, Nonparametric;  Young Adult, Adult;  Age of Onset;  Female;  Greece;  Humans;  Kaplan-Meier Estimate;  Male;  Multiple Sclerosis;  Retrospective Studies;  Severity of Illness Index;  Statistics, Nonparametric;  Young Adult",
    abstract = "Background/Aims: The onset of multiple sclerosis (MS) in Greece has not been systematically studied. We sought to provide data on the onset of MS in Greece with detailed information regarding initial symptoms, and to confirm the prognostic significance of demographic and clinical factors at onset. Methods: We studied 1,034 consecutive patients with MS and independently assessed 265 patients 'seen at onset'. We used the MS severity score and survival analysis (time to reach an Expanded Disability Status Scale score of 4.0) to evaluate the prognostic significance of factors at onset. Results: Female-to-male ratio was 1.9:1 and mean age at onset was 30.7 ± 9.9 years. MS was primary progressive in 9.6%. Initial symptoms were optic neuritis in 20.1%, brainstem dysfunction in 14.7%, dysfunction of long tracts in 49.3%, cerebral dysfunction in 1% and a combination of symptoms in 14.9%. In 'seen at onset' patients, detailed data on initial symptoms are presented. Female gender, earlier age at onset, 'bout onset' and onset with optic neuritis were associated with less severe disease and longer time to disability. Conclusion: The onset of MS in Greece is similar to Western populations. Initial symptoms are within the expected spectrum. Prognostic significance of factors at onset is as previously identified. Copyright © 2010 S. Karger AG."
}