A retrospective review of patients with clinically definite multiple sclerosis.

Multiple sclerosis (MS) is an uncommon disease in Singapore. We retrospectively reviewed our experience from a large single medical institution to identify prominent clinical features and forms of this disease. Of the 21 patients entered into the study, 10 patients developed optic-spinal symptoms over the course of their illness. None of these patients with optic-spinal symptoms had Devic's disease. Unusual clinical manifestations included paroxysmal symptoms either at presentation or during the course of their illness in 3 patients. While cerebrospinal fluid oligoclonal bands were present in only 4 patients, the majority of patients had abnormal neurophysiology and neuroimaging studies. Due to the presence of autoimmune markers in a significant number of cases, we recommend that as part of the initial evaluation for MS, an underlying collagen vascular disorder should be excluded.