Prevalence of Neurological and Non-neurological Complaints Among Patients Visiting the Emergency Department with Multiple Sclerosis: A Cross-sectional Study in Sina Hospital, Tehran, Iran

Background: Patients with multiple sclerosis (MS) visit Emergency Departments (ED) due to both neurological and non-neurological symptoms. Objectives: Our main aim was to study some epidemiologic features of the ED visits of MS cases in a referral hospital. Methods: This cross-sectional study was conducted during 22 September 2018 - 21 September 2019 in Sina Hospital, Tehran, Iran. Admission causes were divided into two categories: patients admitted because of neurological complaints (MS true attacks and pseudo attacks) and patients admitted due to non-neurological reasons that may or may not be related to the disease. To compare the differences between the two categories, t and χ2 tests were used. Results: A total of 375 visits by 346 MS patients were reviewed. We observed that 239 (63.7%) visits were due to neurologic complaints, of which 213 (89.1%) were diagnosed with true MS relapses. Moreover, 136 visits were because of non-neurologic complaints, with urinary tract infection (UTI) being the most common complaint. The patients with MS visiting the ED were mostly female, though there was no significant difference between men and women diagnosed with true relapses (P = 0.154). Patients with neurologic symptoms were significantly younger than those with non-neurologic symptoms (P = 0.007). Our findings showed that 90% of patients with neurological symptoms underwent magnetic resonance imaging (MRI), and the yield of MRI was about 50%. Furthermore, the duration of admission was significantly higher in patients with neurological symptoms (P < 0.001) Conclusions: MS relapse was the most frequent cause of ED visits by individuals with MS. There were also many ED visits by MS patients due to non-neurological causes, and the UTI was the most prevalent chief complaint.