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 nonneurological 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 2 tests were used. Results: A total of 375 visits by 346MSpatients 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 mostcommoncomplaint. The patients withMSvisiting the ED were mostly female, though there was no significant difference betweenmenandwomendiagnosed 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.