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Eight-one patients with a first attack of isolated optic neuritis,40 with Uhthoff's symptom(Group 1)and 41 without(Group 2),were studied.All had a neurovisual examination,74 of 81 patients had the pattern visual evoked potential recorded at rest,and 43 had magnetic resonance imaging brain scans.The pattern visual evoked potential P100 latency was prolonged,Group 1 with a mean of 136+/-19 msec,Group 2 with a mean of 131+/-19 msec (control subjects,102+/-5 msec;n=84),and the P100 amplitude was reduced, without significant difference between the groups.Abnormal magnetic resonance imaging scans were present in significantly more patients in Group 1(p<0.025).Treatment of optic neuritis with corticosteroids had no effect on the evolution or duration of Uhthoff's symptom.Overall,35 of 81 (43%)patients,followed for a mean of 3.5 years,developed multiple sclerosis.The incidence was significantly greater in Group 1(p<0.01). Uhthoff's symptom also correlated with a higher incidence of recurrent optic neuritis.We conclude that Uhthoff's symptom is a prognostic indicator for the early development of multiple sclerosis. |
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