cqvip:Optic neuritis presentations are thought to have a better prognosis.The aim of our study was to compare conversion to multiple sclerosis on the different topo graphies of CISs. We prospectively evaluated 320 patients with CISs (123 with op ticneuritis, 78 with brainstem syndromes, 89 with spinal cord syndromes,and 30 w ith other topographies) who were observed for a median of 39 months. Patients un derwent brain MRI within 3 months of their first attack and again 12 months late r.Conversion to multiple sclerosis determined either clinically or by MRI was ev aluated according to topography. Baseline MRI was normal in 49.2%of patients wi th optic neuritis compared with 24%in brainstem syndromes, 24%in spinal cord s yndromes, and 18.5%in other syndromes. Optic neuritis behaved differently from the other CISs for lower conversion to clinically definite multiple sclerosis an d smaller proportion of patients fulfilling MRI dissemination in space, time, or both.Nevertheless, when only patients with abnormal cranial MRI results at base line were selected, no differences for clinical or MRI conversion were found. Op tic neuritis has a smaller risk for conversion to multiple sclerosis. Neverthele ss, MRI at baseline, not CIS topography, appears to be the crucial issue at mult iple sclerosis presentation.
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