Radiologic isolated syndrome in the early postpartum period (case report)
https://doi.org/10.21886/2219-8075-2025-16-3-22-29
Abstract
The terms radiologic isolated syndrome (RIS) and clinically isolated syndrome (CIS) are currently used in practical healthcare. RIS are foci in the white matter of the brain detected on MRI, which are oſten interpreted as a demyelinating process and suggest the presence of multiple sclerosis (MS) in patients. These changes do not have clinical manifestations and neurologic symptoms characteristic of MS. Multiple sclerosis (MS) is a chronic progressive disease of the central nervous system. MS is widespread among women of reproductive age, which poses a challenge to both obstetricians and neurologists in terms of addressing the planning and management of pregnancy and childbirth. Therefore, the clinical and prognostic significance of these changes in patients with RIS remains controversial. But it is undeniable that patients with RIS are at high risk of developing MS: about 2/3 of patients have progression according to MRI and about 1/3 of patients have clinical symptoms within 5 years of follow-up. In the case that we would like to present to you, a separate clinical episode developed against the background of RIS, manifested by a seizure syndrome in the postpartum (aſter cesarean section) period, which suggested that this was the debut of CIP against the background of an existing but undetected RIS. This prompted us to describe this case and present it to researchers and practicing physicians.
About the Authors
I. A. LoginovRussian Federation
Igor A. Loginov, Cand. Sci. (Med.), аssociate Professor, аssociate Professor of the Department of оbstetrics and gynecology No. 1
Rostov-on-Don
Competing Interests:
Authors declares no conflict of interest
A. A. Borsheva
Russian Federation
Alla A. Borsheva, P.h.D, associate Professor, associate Professor of the Department of obstetrics and gynecology No. 1
Rostov-on-Don
Competing Interests:
Authors declares no conflict of interest
A. N. Latynin
Russian Federation
Andrey N. Latynin, the deputy chief physician for obstetrics and gynecology
Rostov-on-Don
Competing Interests:
Authors declares no conflict of interest
References
1. Peng A, Qiu X, Zhang L, Zhu X, He S, et al. Natalizumab exposure during pregnancy in multiple sclerosis: a systematic review. J Neurol Sci. 2019;396:202-205. https://doi.org/10.1016/j.jns.2018.11.026
2. MacDonald SC, McElrath TF, Hernández-Díaz S. Pregnancy Outcomes in Women With Multiple Sclerosis. Am J Epidemiol. 2019;188(1):57-66. https://doi.org/10.1093/aje/kwy197
3. Goncharova Z.A., Pogrebnova Yu.Y., Trinitatskiy Yu.V., Sycheva T.V. Familial multiple sclerosis: literature review, analysis of own data. Practical medicine. 2020;18(5):69-75. (In Russ.) https://doi.org/10.32000/2072-1757-2020-5-69-75
4. Zakroyshchikova I.V., Simaniv T.O., Zemlyanaya D.O., Timofeeva A.A., Zakharova M.N. The effect of pregnancy on multiple sclerosis. S.S. Korsakov Journal of Neurology and Psychiatry. 2024;124(7-2):43-49. (In Russ.) https://doi.org/10.17116/jnevro202412407243
5. Jesus-Ribeiro J, Correia I, Martins AI, Fonseca M, Marques I, et al. Pregnancy in Multiple Sclerosis: A Portuguese cohort study. Mult Scler Relat Disord. 2017;17:63-68. https://doi.org/10.1016/j.msard.2017.07.002
6. Yong HY, McKay KA, Daley CGJ, Tremlett H. Drug exposure and the risk of multiple sclerosis: A systematic review. Pharmacoepidemiol Drug Saf. 2018;27(2):133-139. https://doi.org/10.1002/pds.4357
7. Nguyen AL, Havrdova EK, Horakova D, Izquierdo G, Kalincik T, et al. Incidence of pregnancy and disease-modifying therapy exposure trends in women with multiple sclerosis: A contemporary cohort study. Mult Scler Relat Disord. 2019;28:235-243. https://doi.org/10.1016/j.msard.2019.01.003
8. Vidal-Jordana A, Montalban X. Multiple Sclerosis: Epidemiologic, Clinical, and Therapeutic Aspects. Neuroimaging Clin N Am. 2017;27(2):195-204. https://doi.org/10.1016/j.nic.2016.12.001
9. Kamm CP, Muehl S, Mircsof D, Müller S, Czaplinski A, et al. Role of Family Planning in Women With Multiple Sclerosis in Switzerland: Results of the Women With Multiple Sclerosis Patient Survey. Front Neurol. 2018;9:821. https://doi.org/10.3389/fneur.2018.00821
10. Lebrun C, Le Page E, Kantarci O, Siva A, Pelletier D, et al. Impact of pregnancy on conversion to clinically isolated syndrome in a radiologically isolated syndrome cohort. Mult Scler. 2012;18(9):1297-1302. https://doi.org/10.1177/1352458511435931
11. Briukhov VV, Popova EV, Krotenkova MV, Boĭko AN. Radiologically isolated syndrome — MRI criteria and management tactic. S.S. Korsakov Journal of Neurology and Psychiatry. 2016;116(10-2):47-52. (In Russ.) https://doi.org/10.17116/jnevro201611610247-52
12. Murashko A.V., Muravin A.I., Popova E.V., Ryabov S.A. Analysis of pregnancy and childbirth in women with multiple sclerosis: a prospective study. Annals of Clinical and Experimental Neurology. 2019;13(4):5-9. (In Russ.) https://doi.org/10.25692/ACEN.2019.4.1
Review
For citations:
Loginov I.A., Borsheva A.A., Latynin A.N. Radiologic isolated syndrome in the early postpartum period (case report). Medical Herald of the South of Russia. 2025;16(3):22-29. (In Russ.) https://doi.org/10.21886/2219-8075-2025-16-3-22-29