Prevalence of edema of the lower limbs in MS patients: a vascular and lymphoscintigraphic study.

·     (Lymphoscintigraphy - use of a radio-nuclear agent to demonstrate a lymphatic drainage system)

The aim of the study was to evaluate the frequency of edema of the lower limbs in multiple sclerosis (MS) patients utilizing a multidisciplinary approach. 

A total of 205 patients with definite MS were included in the study. 

Ø     75 were male and

Ø     130 female,

Ø     mean age of 50.53,

Ø     mean Expanded Disability Status Scale (EDSS) score of 5.27

Ø     mean disease duration of 16.6 years. 

·          71 patients had a relapsing-remitting (RR) disease course,

·          85 were secondary progressive (SP) and

·          49 were primary progressive (PP). 

·          93 patients (45%) showed edema at the examination. 

EDSS, disease duration and disease course, but not gender, were statistically different between edema and non-edema patients. 

Out of

93 patients with edema,

69 agreed to undergo a vascular examination. 

Of the 69 patients:

45 (65.2%) had a CEAP score (specific rating scale for edema) of 3 (presence of edema) and

24 (34.8%) had a score of 4 (presence of a trophic disorder). 

Out of 69 subjects,

33 agreed to undergo a lymphoscintigraphy, which was normal in only 29 extremities out of 66. 

Lower limb edema is common in MS patients, especially in those with reduced mobility.  Early screening is advised in patients with an elevated EDSS.

Department of Neurology,

PA Micone Hospital,

Genoa, Italy