Table 1: Severity of 248 MS Attacks, According to Attack-Related Characteristics

Severitya
very mild mild moderate severe
Predictive Factor N % N % N % N % p-valueb
Number of FSs involved
Monosymptomatic 52 34.9 60 40.3 29 19.5 8 5.4
Bisymptomatic 9 15.8 18 31.6 19 33.3 11 19.3 <0.0001c
Polysymptomatic 4 9.5 11 26.2 11 26.2 16 38.1
Type of FS involvedd
Pyramidal yes 18 18.4 33 33.7 24 24.5 23 23.5 =0.003
no 47 31.3 56 37.3 35 23.3 12 8.0
Cerebellar yes 6 18.8 7 21.9 9 28.1 10 31.3 n.s
no 59 27.3 82 38.0 50 23.2 25 11.6
Brainstem yes 5 9.8 15 29.4 19 37.3 12 23.5 <0.001
no 60 30.5 74 37.6 40 20.3 23 11.7
Visual yes 16 23.2 28 40.6 13 18.8 12 17.4 n.s
no 49 27.4 67 34.1 46 25.7 23 12.9
Sphincteric yes 4 17.4 6 26.1 6 26.1 7 30.4 n.s
no 61 27.1 83 36.9 53 23.6 28 12.4
Sensory yes 32 24.8 44 34.1 30 23.3 23 17.8 n.s
no 33 27.7 45 37.8 29 24.4 12 10.1
Total attack duratione
Short 21 25.3 38 45.8 18 21.7 6 7.2
Intermediate 32 36.0 26 29.2 19 21.4 12 13.5 =0.003c
Long 12 15.8 25 32.9 22 29.0 17 22.4
Therapy
No 25 38.5 20 30.8 13 20.0 7 10.8
Oral 20 34.5 24 41.4 12 20.7 2 3.5 =0.001
Intravenous 20 16.0 45 36.0 34 27.2 26 20.8

a Severity was graded according to the difference between the EDSS score at the day of maximum worsening and the EDSS score before the onset of the relapse, as: very mild (0 or 1 point), mild (1.5 or 2 points), moderate (2.5 or 3 points), and severe (3.5 points or more).
b Level of significance at 0.003 according to the Bonferroni correction.
c Denotes the chi-square for trend test.
d Here the type of FS (except mental and others) involved in each attack is cross-tabulated against grade of severity.
e Calculated as the time between the date of onset of the first symptom and the date of maximum improvement of the last symptom and categorized as short (≤ 30 days), intermediate (31-60 days) and long (>60 days).
The following factors were not statistically related to severity: age at onset of the attack (<30, 30-39, ≥40), season of onset of the attack, infections in the preceding month, speed of onset (calculated as the time between the date of onset and the date of zenith and categorized as acute if the same day, subacute if 2-3 days, and chronic >3 days), gender, age at first attack (<30, 30-39, ≥40), season of birth and of first attack, oligoclonal bands at CSF examination (present/absent), Link Index (≤ 0.70/>0.70) CSF IgG value (≤ 0.40/>0.40 mg/dl), total number of lesions (0,1-8, ≥9 lesions), and number of gadolinium-enhancing lesions at first brain MRI (0,1, >1 lesions), and recovery after the first relapse (complete/incomplete).