Functional impairments and disability profile of CNS non-MS inflammatory demyelinating diseases: A hospital-based study

Noor M, Mir FA, Asimi R, Bhat MA, Choh NA, Wani MM, Masoom I, Qazi Z, Shah UA, Najar AS, Bashir A

Pdf Page Numbers :- 245-251

Murtaza Noor^1,*, Feroze A Mir¹, Ravouf Asimi¹, Mushtaq Ahmad Bhat², Naseer Ahmad Choh³, Mohammad Maqbool Wani¹, Injeela Masoom¹, Zahid Qazi¹, Usaid Ali Shah¹, Anisa Shafi Najar¹, and Adil Bashir¹

¹Department of Neurology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir – 190011

²Department of Pediatrics, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir – 190011

³Department of Radiodiagnosis and Imaging, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir – 190011

*Corresponding author: Dr. Murtaza Noor, Senior Resident, Department of Neurology, Sher-i-Kashmir Institute of Medical Sciences, Soura, Srinagar, Jammu & Kashmir – 190011. Email: murtaza.noor7@gmail.com

Received 25 March 2025; Revised 13 June 2025; Accepted 20 June 2025; Published 27 June 2025

Citation: Noor M, Mir FA, Asimi R, Bhat MA, Choh NA, Wani MM, Masoom I, Qazi Z, Shah UA, Najar AS, Bashir A. Functional impairments and disability profile of CNS non-MS inflammatory demyelinating diseases: A hospital-based study. J Med Sci Res. 2025; 13(3):245-251. DOI: http://dx.doi.org/10.17727/JMSR.2025/13-43

Copyright: © 2025 Noor M et al. Published by KIMS Foundation and Research Center. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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Abstract

Background: Non-MS CNS inflammatory demyelinating diseases are pathologically primary demyelination caused by immunological injury to oligodendrocytes and as a result are clinically severe and can present either as clinically isolated syndromes or recurrent episodes with residual disability.

Methods: A cross-sectional observational study was conducted on 65 patients with different non-MS CNS inflammatory demyelinating diseases to study their course (monophasic or recurrent) and the functional impairments such as extent of fatigue, depression (PHQ9 score), motor disability (EDSS score) and bladder-bowel dysfunction (using bladder and bowel control scores respectively). Respective standard scales were used for paediatric groups. The data was then analysed by appropriate statistical methods and observations recorded.

Results: Neuromyelitis optica spectrum disorder (NMOSD) and myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) cases had a monophasic and a recurrent course in comparable frequencies, while ADEM and idiopathic groups were strictly monophasic. Highest EDSS at onset was noted in NMOSD, ADEM and LETM reflecting their disabling nature. EDSS declined significantly (p=0.04) from onset to discharge but idiopathic LETM and NMOSD had residual disability. There was significant fatigue seen in most groups but with no significant association with disease type and recurrence (p =0.44). Depression was also co-prevalent but again had no significant association with disease groups and number of episodes (p =0.66). Bladder-bowel dysfunction was severe and significant (p<0.001) among NMOSD, ADEM and LETM cases.

Conclusion: This study showed a significant functional disability experienced by patients of non-MS CNS inflammatory demyelinating diseases in terms of fatigue, depression, motor weakness and bladder-bowel dysfunction; and underscores the need to recognise them early, as the motor disability scores declined significantly at discharge.

Keywords: central nervous system; primary demyelination; NMOSD; myelin; oligodendrocyte; encephalomyelitis; myelitis; idiopathic optic neuritis