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

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Abstract

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.

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Authors and Affiliations

  1. Hospital Regional Universitario Carlos Haya, Málaga, Spain

    O. Fernández, V. Fernández & E. de Ramón

  2. Hospital de Bellvitge, Barcelona, Spain

    T. Arbizu

  3. Hospital Virgen de la Macarena, Seville, Spain

    G. Izquierdo

  4. Hospital La Fe, Valencia, Spain

    I. Bosca

  5. Hospital San Carlos, Madrid, Spain

    R. Arroyo

  6. Hospital Puerta de Hierro, Madrid, Spain

    J. A. García Merino

Authors
  1. O. Fernández
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  2. V. Fernández
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  3. T. Arbizu
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  4. G. Izquierdo
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  5. I. Bosca
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  6. R. Arroyo
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The Novo Group

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Correspondence to O. Fernández.

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The co-authors of the Novo Group are given in Appendix.

Appendix

Appendix

Co-authors of the Novo Group (hospital, province, number of cases included-bold in brackets, investigators):

1. H de Bellvitge, Barcelona (36) Txomin Arbizu, Lucía Romero Pinel, Laura Gubieras. 2. H Virgen de la Macarena, Seville (20) Guillermo Izquierdo Ayuso, Yersinia Tordecilla Echenique. 3. H La Fe, Valencia (15) Isabel Bosca. 4. H Carlos Haya, Malaga (12) Óscar Fernández, Ana Alonso Torres. 5. H San Carlos, Madrid (10) Rafael Arroyo, Manuel Bartolomé Puras, Virginia de las Heras. 6. H Puerta de Hierro, Madrid (10) Juan Antonio García Merino, Carmen Martín 7. H Central De Asturias, Oviedo (9) Ciara García Fernández. 8. H Río Hortega, Valladolid (9) Wadih Bowakin Dib. 9. H Vall Hebron, Barcelona (8) Xavier Montalbán, Héctor D. Perkal. 10. H Valme, Seville (7) Carmen Fernández. 11. H Miguel Servet, Zaragoza (4) Jesús Martín Martinez. 12. H Conxo Xus, Santiago (3) Manuel Arias Gómez. 13. H Virgen de la Salud, Toledo (3). Mª Rosa García Montero. 14. H Ramón y Cajal, Madrid (3) José Carlos Álvarez Cermeño.

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Fernández, O., Fernández, V., Arbizu, T. et al. Characteristics of multiple sclerosis at onset and delay of diagnosis and treatment in Spain (The Novo Study). J Neurol 257, 1500–1507 (2010). https://doi.org/10.1007/s00415-010-5560-1

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