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MS Patients Visit ER for Non-MS Symptoms


AAN: MS Patients Visit ER for Non-MS Symptoms

[if: A similar study for ME/CFS would be interesting.]

This report is part of a 12-month Clinical Context series.
By Ed Susman, Contributing Writer, MedPage Today
Published: April 14, 2010
Reviewed by Ari Green, MD; Assistant Professor, University of California, San Francisco and
Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner Earn CME/CE credit for reading medical news

Action Points

* Explain to interested patients that people with multiple sclerosis patients who visit emergency departments may need to be evaluated for comorbidities that may not be related to their underlying disease.

* Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.

TORONTO -- Multiple sclerosis patients who visited a busy urban emergency department in the U.S. were often seeking treatment for non-neurological symptoms, researchers said here.

"We found that the multiple sclerosis patients tended to be underinsured, tend to have higher levels of disability, and are under-treated with disease-modifying therapies," Svenja Oynhausen, MD, of the University Hospital of Bonn in Germany, told attendees at the annual meeting of the American Academy of Neurology.

Oynhausen reviewed data on 224 patients who made 569 emergency department visits while she was training at Mount Sinai School of Medicine in New York City.

"More than half of the patients' visits (54.7%) were for medical services unrelated to their MS neurological symptoms," she said at a poster presentation. MS-related symptoms accounted for 25.6% of the visits.

"Recognizing that medical comorbidities and indirectly-related complications of multiple sclerosis are the major cause of emergency department visits for multiple sclerosis patients, caution should be observed to avoid overascribing symptoms of an acutely ill multiple sclerosis patient to the underlying diagnosis of multiple sclerosis," Oynhausen told MedPage Today.

She and colleagues said they undertook the retrospective study because relatively little attention has been paid to the urgent care needs of multiple sclerosis patients.

Oynhausen scrutinized medical records of the patients treated at Mount Sinai's emergency department from January 2005 through December 2007. Almost 74% of the multiple sclerosis patients seen in the emergency department were women, and the mean age of the patients was 47.7 years.

The patients had received a multiple sclerosis diagnosis for a mean of 12 years, and 42.4% had the relapsing-remitting form of the disease.

Lily Jung, MD, medical director of the Neurology Clinic and chief of neurology at Swedish Medical Center, Seattle, acting as a spokesperson for the American Academy of Neurology, told MedPage Today, "The non-multiple sclerosis presenting symptoms should remind us that these patients can have other, more common, comorbidities."

Jung said multiple sclerosis patients in later stage of disease tend to lose their insurance due to their disability.

"Lack of disease modifying therapy may again be due to disability and subsequent loss of insurance," she said.

Oynhausen did not disclose any industry financial relationships. Her study did not receive industry support. Jung disclosed financial relationships with Novartis and Biogen.

Primary source: American Academy of Neurology
Source reference:
Oynhausen S, et al "Emergency medical care of multiple sclerosis patients (data from the Mount Sinai Resource Utilization in MS Project [RESUMS])" AAN 2010; Abstract P01.182.