Sepehri N. Clinically isolated syndrome: neurological manifestations, diagnosis and prognosis for transformation to the multiple sclerosis

Dissertation is devoted to studying the clinical features of clinically isolated syndrome and risk factors for its transformation to the multiple sclerosis as well as risk prediction. The most frequent clinical variants of the clinically isolated syndrome (KIS) have been determined. Described have been the MRT images of different variants of KIS and MRT-predicted risk factors for its transformation to the multiple sclerosis. Unifocal lesion occurred in 13% of patients, multifocal - in 87%. Combined lesions were more common in the following locations of the brain: periventricular region and the corpus callosum, the frontal and parietal lobes, as well as the periventricular region and parietal lobes.Neuroimmunologic investigations have proved autoimmune direction of immune processes in patients. When determining the HLA-genotype in the patients, the protective alleles and risk ones were separated. In the patients with MS, the most often observed alleles were as follows: DQB1 *06, DRB5 *01 and DRB1 *15. In this case, DQB1*06 acted as a positive factor and reduced the risk of transformation of clinically isolated syndrome to the multiple sclerosis. The developed mathematical model predicting the risk of transformation of clinically isolated syndrome to the multiple sclerosis is based on using the following signs: the number and topography of localization of demyelinating lesions on MRT images, presence of perifocal edema, HLA-alleles.The necessity of applying the pulse dose administration of methylprednisolone in combination with diprospan parabulbar administration for patients with retrobulbar neuritis has been grounded, which greatly affects the dynamics of the ophthalmological marks and results of curing the optic neuritis.