Research Article
Volume 12 Issue 10 - 2020
Cerebellar and Polysymptomatic Onset as Long Term Disability Factors in Mexican Multiple Sclerosis Patients
Ricardo Jorge García-Bermúdez, Alejandra Calderón-Vallejo, Raúl Carrera-Pineda and Brenda Bertado-Cortés*
Department of Neurology, Mexican Social Security Institute, Mexico City, Mexico
*Corresponding Author: Brenda Bertado-Cortés, Department of Neurology, Mexican Social Security Institute, Mexico City, Mexico..
Received: September 21, 2020; Published: September 30, 2020


Introduction: Multiple sclerosis is one of the main causes of disability in young people. Multiple factors have been related with poor prognosis, including onset relapse. In Mexican population there are no studies about onset relapse and prognosis in multiple sclerosis.

Materials and Methods: We analyzed demographic and clinical characteristics of patients with multiple sclerosis diagnosis during hospitalization between January 2017 to December 2019, at Specialities Hospital of “Siglo XXI” National Medical Center, in Mexico city, Mexico, with a six months follow up and disability evaluation by EDSS. We performed chi squared of relapse onsets and smoking and the risk of developing an EDSS of 2.5 or higher (median EDSS of our population).

Results and Discussion: 75 patients were diagnosed with multiple sclerosis, but only 73 completed the six months follow up. By six months follow up, the RR for EDSS of 2.5 or higher in patients with cerebellar onset was 1.01 (p = 0.687) and for polysymptomatic onset 0.29 (p = 0.141). Motor onset had a RR of 2.46 (p = 0.027) and smoking patients had a RR of 2.89 (p = 0.007). Unlike other studies, in Mexican populations with multiple sclerosis cerebellar and polysymptomatic onset are not risk factors for a greater disability while motor onset and smoking have a similar risk with other populations.

Conclusion: Cerebellar and polysymptomatic onset are not risk factors for long term disability in our population, while motor onset and smoking are risk factors.

Keywords: Multiple Sclerosis; Cerebellar Onset; Polysymptomatic Onset; Smoking; Disability; Prognosis


  1. Dargahi N., et al. “Multiple sclerosis: Immunopathology and treatment update”. Brain Sciences 78 (2017): 1-27.
  2. Kobelt G., et al. “New insights into the burden and costs of multiple sclerosis in Europe”. Multiple Sclerosis Journal 8 (2017): 1123-1136.
  3. GBD 2016 Multiple Sclerosis Collaborators. “Global, regional, and national burden of multiple sclerosis 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016”. The Lancet Neurology 18 (2019): 269-285.
  4. Hirst C., et al. “Increasing prevalence and incidence of multiple sclerosis in South East Wales”. Journal of Neurology, Neurosurgery, and Psychiatry 80 (2009): 386-391.
  5. Melcon M., et al. “Towards establishing MS prevalence in Latin America and the Caribbean”. Multiple Sclerosis Journal 2 (2012): 145-152.
  6. Bertado-Cortés B., et al. “Características clínicas y demográficas de los pacientes con esclerosis multiple”. Revista medica del Instituto Mexicano del Seguro Social 2 (2016): 186-190.
  7. Rotstein D and Montalban X. “Reaching an evidence-based prognosis for personalized treatment of multiple sclerosis”. Nature Reviews Neurology 15 (2019): 287-300.
  8. Tomassini V., et al. “Predicting the profile of increasing disability in multiple sclerosis”. Multiple Sclerosis Journal 9 (2019): 1306-1315.
  9. Scalfari A., et al. “The natural history of multiple sclerosis, a geographically based study 10: relapses and long-term disability”. Brain 133 (2010): 1914-1929.
  10. Rzepiński L., et al. “Early clinical features, time to secondary progression, and disability milestones in polish multiple sclerosis patients”. Medicina232 (2019): 1-12.
  11. Tiftikcioglu B., et al. “Long-term disability and progression in spinal onset multiple sclerosis”. Acta Neurologica Belgica 118 (2018): 217-225.
  12. Novotna M., et al. “Poor early relapse recovery affects onset of progressive disease course in multiple sclerosis”. Neurology 85 (2015): 722-729.
  13. Alla S., et al. “Disability profile of multiple sclerosis in New Zealand”. Journal of Clinical Neuroscience 28 (2016): 97-101.
  14. Leone M., et al. “Factors predicting incomplete recovery from relapses in multiple sclerosis: a prospective study”. Multiple Sclerosis Journal 14 (2008): 485-493.
  15. Ferreira C., et al. “Prognostic factors associated with long-term disability and secondary progression in patients with multiple sclerosis”. Multiple Sclerosis and Related Disorders 8 (2016): 27-34.
  16. Gholipour T., et al. “Demographic and clinical characteristics of malignant multiple sclerosis”. Neurology 76 (2011): 1996-2001.
  17. Leray E., et al. “Epidemiology of multiple sclerosis”. Revue Neurologique 172 (2016): 3-13.
  18. Scalfari A., et al. “Age and disability accumulation in multiple sclerosis”. Neurology 77 (2011): 1246-1252.
  19. Andrijauskisa D., et al. “Clinical and diagnostic features of patients with familial multiple sclerosis”. Medical Hypotheses 131 (2019): 1-5.
  20. Paz-Ballesteros W., et al. “Cigarette Smoking, Alcohol Consumption and Overweight in Multiple Sclerosis: Disability Progression”. Archives of Medical Research 48 (2017): 113-120.
  21. Damasceno A., et al. “Prognostic indicators for long-term disability in multiple sclerosis patients”. Journal of the Neurological Sciences 324 (2013): 29-33.
  22. Briggs F., et al. “Prognostic factors of disability in relapsing remitting multiple sclerosis”. Multiple Sclerosis and Related Disorders 30 (2019): 9-16.
  23. Sartori A., et al. “Can we predict benign multiple sclerosis? Results of a 20-year long-term follow-up study”. Journal of Neurology 6 (2017): 1068-1075.
  24. Tintore M., et al. “Defining high, medium and low impact prognostic factors for developing multiple sclerosis”. Brain 138 (2015): 1863-1874.
Citation: Brenda Bertado-Cortés., et al. “Cerebellar and Polysymptomatic Onset as Long Term Disability Factors in Mexican Multiple Sclerosis Patients”. EC Neurology 12.10 (2020): 81-85.

PubMed Indexed Article

EC Pharmacology and Toxicology
LC-UV-MS and MS/MS Characterize Glutathione Reactivity with Different Isomers (2,2' and 2,4' vs. 4,4') of Methylene Diphenyl-Diisocyanate.

PMID: 31143884 [PubMed]

PMCID: PMC6536005

EC Pharmacology and Toxicology
Alzheimer's Pathogenesis, Metal-Mediated Redox Stress, and Potential Nanotheranostics.

PMID: 31565701 [PubMed]

PMCID: PMC6764777

EC Neurology
Differences in Rate of Cognitive Decline and Caregiver Burden between Alzheimer's Disease and Vascular Dementia: a Retrospective Study.

PMID: 27747317 [PubMed]

PMCID: PMC5065347

EC Pharmacology and Toxicology
Will Blockchain Technology Transform Healthcare and Biomedical Sciences?

PMID: 31460519 [PubMed]

PMCID: PMC6711478

EC Pharmacology and Toxicology
Is it a Prime Time for AI-powered Virtual Drug Screening?

PMID: 30215059 [PubMed]

PMCID: PMC6133253

EC Psychology and Psychiatry
Analysis of Evidence for the Combination of Pro-dopamine Regulator (KB220PAM) and Naltrexone to Prevent Opioid Use Disorder Relapse.

PMID: 30417173 [PubMed]

PMCID: PMC6226033

EC Anaesthesia
Arrest Under Anesthesia - What was the Culprit? A Case Report.

PMID: 30264037 [PubMed]

PMCID: PMC6155992

EC Orthopaedics
Distraction Implantation. A New Technique in Total Joint Arthroplasty and Direct Skeletal Attachment.

PMID: 30198026 [PubMed]

PMCID: PMC6124505

EC Pulmonology and Respiratory Medicine
Prevalence and factors associated with self-reported chronic obstructive pulmonary disease among adults aged 40-79: the National Health and Nutrition Examination Survey (NHANES) 2007-2012.

PMID: 30294723 [PubMed]

PMCID: PMC6169793

EC Dental Science
Important Dental Fiber-Reinforced Composite Molding Compound Breakthroughs

PMID: 29285526 [PubMed]

PMCID: PMC5743211

EC Microbiology
Prevalence of Intestinal Parasites Among HIV Infected and HIV Uninfected Patients Treated at the 1o De Maio Health Centre in Maputo, Mozambique

PMID: 29911204 [PubMed]

PMCID: PMC5999047

EC Microbiology
Macrophages and the Viral Dissemination Super Highway

PMID: 26949751 [PubMed]

PMCID: PMC4774560

EC Microbiology
The Microbiome, Antibiotics, and Health of the Pediatric Population.

PMID: 27390782 [PubMed]

PMCID: PMC4933318

EC Microbiology
Reactive Oxygen Species in HIV Infection

PMID: 28580453 [PubMed]

PMCID: PMC5450819

EC Microbiology
A Review of the CD4 T Cell Contribution to Lung Infection, Inflammation and Repair with a Focus on Wheeze and Asthma in the Pediatric Population

PMID: 26280024 [PubMed]

PMCID: PMC4533840

EC Neurology
Identifying Key Symptoms Differentiating Myalgic Encephalomyelitis and Chronic Fatigue Syndrome from Multiple Sclerosis

PMID: 28066845 [PubMed]

PMCID: PMC5214344

EC Pharmacology and Toxicology
Paradigm Shift is the Normal State of Pharmacology

PMID: 28936490 [PubMed]

PMCID: PMC5604476

EC Neurology
Examining those Meeting IOM Criteria Versus IOM Plus Fibromyalgia

PMID: 28713879 [PubMed]

PMCID: PMC5510658

EC Neurology
Unilateral Frontosphenoid Craniosynostosis: Case Report and a Review of the Literature

PMID: 28133641 [PubMed]

PMCID: PMC5267489

EC Ophthalmology
OCT-Angiography for Non-Invasive Monitoring of Neuronal and Vascular Structure in Mouse Retina: Implication for Characterization of Retinal Neurovascular Coupling

PMID: 29333536 [PubMed]

PMCID: PMC5766278

EC Neurology
Longer Duration of Downslope Treadmill Walking Induces Depression of H-Reflexes Measured during Standing and Walking.

PMID: 31032493 [PubMed]

PMCID: PMC6483108

EC Microbiology
Onchocerciasis in Mozambique: An Unknown Condition for Health Professionals.

PMID: 30957099 [PubMed]

PMCID: PMC6448571

EC Nutrition
Food Insecurity among Households with and without Podoconiosis in East and West Gojjam, Ethiopia.

PMID: 30101228 [PubMed]

PMCID: PMC6086333

EC Ophthalmology
REVIEW. +2 to +3 D. Reading Glasses to Prevent Myopia.

PMID: 31080964 [PubMed]

PMCID: PMC6508883

EC Gynaecology
Biomechanical Mapping of the Female Pelvic Floor: Uterine Prolapse Versus Normal Conditions.

PMID: 31093608 [PubMed]

PMCID: PMC6513001

EC Dental Science
Fiber-Reinforced Composites: A Breakthrough in Practical Clinical Applications with Advanced Wear Resistance for Dental Materials.

PMID: 31552397 [PubMed]

PMCID: PMC6758937

EC Microbiology
Neurocysticercosis in Child Bearing Women: An Overlooked Condition in Mozambique and a Potentially Missed Diagnosis in Women Presenting with Eclampsia.

PMID: 31681909 [PubMed]

PMCID: PMC6824723

EC Microbiology
Molecular Detection of Leptospira spp. in Rodents Trapped in the Mozambique Island City, Nampula Province, Mozambique.

PMID: 31681910 [PubMed]

PMCID: PMC6824726

EC Neurology
Endoplasmic Reticulum-Mitochondrial Cross-Talk in Neurodegenerative and Eye Diseases.

PMID: 31528859 [PubMed]

PMCID: PMC6746603

EC Psychology and Psychiatry
Can Chronic Consumption of Caffeine by Increasing D2/D3 Receptors Offer Benefit to Carriers of the DRD2 A1 Allele in Cocaine Abuse?

PMID: 31276119 [PubMed]

PMCID: PMC6604646

EC Anaesthesia
Real Time Locating Systems and sustainability of Perioperative Efficiency of Anesthesiologists.

PMID: 31406965 [PubMed]

PMCID: PMC6690616

EC Pharmacology and Toxicology
A Pilot STEM Curriculum Designed to Teach High School Students Concepts in Biochemical Engineering and Pharmacology.

PMID: 31517314 [PubMed]

PMCID: PMC6741290

EC Pharmacology and Toxicology
Toxic Mechanisms Underlying Motor Activity Changes Induced by a Mixture of Lead, Arsenic and Manganese.

PMID: 31633124 [PubMed]

PMCID: PMC6800226

EC Neurology
Research Volunteers' Attitudes Toward Chronic Fatigue Syndrome and Myalgic Encephalomyelitis.

PMID: 29662969 [PubMed]

PMCID: PMC5898812

EC Pharmacology and Toxicology
Hyperbaric Oxygen Therapy for Alzheimer's Disease.

PMID: 30215058 [PubMed]

PMCID: PMC6133268

News and Events

November Issue Release

We always feel pleasure to share our updates with you all. Here, notifying you that we have successfully released the November issue of respective journals and the latest articles can be viewed on the current issue pages.

Submission Deadline for Upcoming Issue

Ecronicon delightfully welcomes all the authors around the globe for effective collaboration with an article submission for the upcoming issue of respective journals. Submissions are accepted on/before December 08, 2021.

Certificate of Publication

Ecronicon honors with a "Publication Certificate" to the corresponding author by including the names of co-authors as a token of appreciation for publishing the work with our respective journals.

Best Article of the Issue

Editors of respective journals will always be very much interested in electing one Best Article after each issue release. The authors of the selected article will be honored with a "Best Article of the Issue" certificate.

Certifying for Review

Ecronicon certifies the Editors for their first review done towards the assigned article of the respective journals.

Latest Articles

The latest articles will be updated immediately on the articles in press page of the respective journals.

Immediate Assistance

The prime motto of this team is to clarify all the queries without any delay or hesitation to avoid the inconvenience. For immediate assistance on your queries please don't hesitate to drop an email to