San Juan MS Center

Author Of 2 Presentations

Epidemiology Late Breaking Abstracts

LB1279 - Initial Symptom at Onset in newly diagnosed Hispanic MS patients between 2017-2019: An Update (ID 2179)

Presentation Number
LB1279
Presentation Topic
Epidemiology

Abstract

Background

Multiple Sclerosis (MS) is an autoimmune disease believed to result from several factors including genetic and environmental factors as well as race and ethnicity. Ethnic differences are recognized as important contributors to presentation of MS. Hispanics are a minority group with minimal information available on characteristics of this disease. However, variability has been shown in the presentation of initial symptom in Hispanic groups as some state that optic neuritis is the most common first symptom while others state sensory symptoms are more predominant. Differences in initial symptom among Hispanic groups may be due to environmental factors as well as genetic influences from different regions of origin.

Objectives

In this study we identify the most frequent initial symptom at onset of newly diagnosed Hispanic MS patients in Puerto Rico (PR).

Methods

Data was analyzed from the PRMS Foundation registry for patients diagnosed from 2017-2019. A total of 383 patients were analyzed, and data was collected through self-reported questionnaires. Descriptive statistics were used for the analysis.

Results

Preliminary results show that 54% of patients had sensory symptoms combined with other symptoms as their initial symptoms, 34% had optic neuritis combined with other symptoms, and lastly, 34% had motor symptoms combined with other symptoms. This trend was also seen when analyzing single symptom presentation as 27% were sensory symptom alone, 16% presented optic neuritis alone, and 8% presented motor symptoms alone.

Conclusions

Differences in clinical traits of MS among Hispanic groups throughout the United States (US) may be due to environmental factors as well as genetic influences from different regions of origin. Our findings underline the importance of identifying MS characteristics among subgroups of Hispanics in the US. Acquisition of this information will assist in increasing awareness of MS in minority groups and more importantly, assist with more rapid identification and diagnosis of MS in Hispanic populations, which will ultimately result in earlier treatment, better quality of care, and increased quality of life.

Collapse
Observational Studies Poster Presentation

P0886 - Multiple Sclerosis diagnosis at USNS Comfort during the aftermath of Hurricane Maria: A Case Report (ID 1870)

Speakers
Presentation Number
P0886
Presentation Topic
Observational Studies

Abstract

Background

The early diagnosis of Multiple Sclerosis (MS) is important for prognosis. On September 20, 2017 Hurricane Maria (HM) passed through Puerto Rico (PR) leaving severe devastation on its path. The electric infrastructure on the island collapsed, gasoline was rationed, medications were scarce and daily living was a challenge for patients with chronic conditions. The island has a high prevalence of MS (70.6/100,000), approximately 156 neurologists and 69 hospitals, most of which were not connected to the electric grid or habitable after the hurricane. Due to the lack of fully operational hospitals and medical offices, patients in need of medical attention did not have many options.

Objectives

We aim to highlight the effects of Hurricane Maria natural disaster in the diagnosis and treatment of an MS patient in Puerto Rico.

Methods

A case review was performed to describe the diagnosis process of a patient during the aftermath of Hurricane Maria on the island.

Results

A 41 y/o Puerto Rican woman had an episode of hemi paresthesia when she was 20y/o it was associated with stress and disregarded. Two weeks prior to HM she was presenting diplopia, internuclear ophthalmoplegia, ataxia and fatigue which worsened immediately after the event. Patient went to a local hospital but she was only referred to a neurologist and discharged. She decided to go on board the USNS Comfort (USNSC) due to the unavailability of medical appointment with neurologists on the island. Due to clinical signs presented and history of symptoms, MS was suspected, but no functional MRI facilities were available to confirm diagnosis. Methylprednisolone was administered and improvement of symptoms was observed. Diagnosis was made without MRI to confirm lesions. Fingolimod was recommended as treatment, but it was not available due to the scarcity of resources and MS treatments. Eventually, fingolimod was provided to the patient. Follow-up with a neurologist for evaluation and MRI of brain performance were advised. Five months after the hurricane, the MRI showed periventricular white matter lesions, some juxtacortical lesions and a single callosal lesion that were not active. Also, black hole was present in the right peri-atrial white matter supporting diagnosis.

Conclusions

This case demonstrates the importance of disaster guidelines for the management of possible diagnosis of MS, availability of functioning MRI facilities and consequent availability of treatment in the hope of preventing progression on these patients. Future work could include creation of collaborations between pharmaceutical companies and MS foundations to receive and distribute DMT samples in case of natural disasters.

Collapse