Characteristics of multiple sclerosis at onset and delay of diagnosis and treatment in Spain (The Novo Study)

• Published in: Journal of neurology Vol. 257; no. 9; pp. 1500 - 1507
• Main Authors: Fernández, O., Fernández, V., Arbizu, T., Izquierdo, G., Bosca, I., Arroyo, R., García Merino, J. A., de Ramón, E.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.09.2010; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Age of Onset; Ambulatory Care Facilities - trends; Antigens; Biological and medical sciences; Child; Clinical medicine; Clinical trials; Diagnostic Tests, Routine - trends; Early Diagnosis; Female; Humans; Magnetic resonance imaging; Male; Medical diagnosis; Medical referrals; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis; Multiple Sclerosis - diagnosis; Multiple Sclerosis - epidemiology; Multiple Sclerosis - therapy; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Neurology; Neuropathology; Neuroradiology; Neurosciences; Original Communication; Patient Acceptance of Health Care; Patients; Quality Assurance, Health Care - methods; Quality of Health Care - statistics & numerical data; Quality of Health Care - trends; Spain - epidemiology; Time Factors; Young Adult; Europe; Spain; Madrid Spain; Early treatment; Multiple sclerosis; Diagnosis; Nervous system diseases; Treatment; Central nervous system disease; Inflammatory disease
• ISSN: 0340-5354; 1432-1459
• DOI: 10.1007/s00415-010-5560-1

Multiple sclerosis (MS) is a disease supposedly of autoimmune origin, with reactivity directed against myelin antigens. From the neuropathological point of view, MS produces inflammation, demyelination and axonal and neuronal degeneration. Inflammatory phenomena are predominant in the initial phase of the disease, followed later by neurodegenerative processes. Over the last decade, early treatment, during the most inflammatory phase of the disease, has been considered the best strategy to treat MS. Accordingly, we decided to determine the periods of delay between the first symptoms and the time to the first medical visit, the time to referral to a specialised MS unit, the delay in undertaking clinical and paraclinical tests, the diagnostic criteria used and the overall delay in diagnosis and treatment. The median time from onset of first symptoms to the first visit to a physician was 19.2 months, which represented the greatest delay. The median time between this initial medical consultation and the confirmation of the diagnosis by a specialised MS unit was 5.7 months, and the overall time from symptom onset to diagnosis was 24.9 months (2.08 years). The median time between onset of the first symptoms and the decision to give the first treatment was 2 years. The most important delay was that from symptom onset to the first medical visit, with the other delays being less. Thus, it is during this initial period that greater effort is required in order to reduce the time to diagnosis, by increasing awareness of the problem of MS among the general population and primary care physicians.