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. 2021 Jan 22:2021:8841281.
doi: 10.1155/2021/8841281. eCollection 2021.

Sensitivity of Awaji Criteria and Revised El Escorial Criteria in the Diagnosis of Amyotrophic Lateral Sclerosis (ALS) at First Visit in a Tunisian Cohort

Bademain Jean Fabrice Ido  1 , Imen Kacem  2 , Mahamadi Ouedraogo  1 , Amina Nasri  2 , Saloua Mrabet  2 , Amina Gargouri  2 , Mouna Ben Djebara  2 , Bawindsongré Jean Kabore  1 , Riadh Gouider  2
Affiliations

Sensitivity of Awaji Criteria and Revised El Escorial Criteria in the Diagnosis of Amyotrophic Lateral Sclerosis (ALS) at First Visit in a Tunisian Cohort

Bademain Jean Fabrice Ido et al. Neurol Res Int. .

Abstract

Background: Amyotrophic lateral sclerosis (ALS) is a fatal disease whose diagnosis and early management can improve survival. The most used diagnostic criteria are the revised El Escorial criteria (rEEC) and Awaji criteria (AC). The comparison of their sensitivities showed contradictory results. Our study aimed to compare the sensitivities of these two criteria in the diagnosis of definite ALS, at first visit, in a Tunisian hospital cohort.

Materials and methods: This was a retrospective study including 173 patients diagnosed with ALS at the Department of Neurology of the Razi Hospital between January 2003 and April 2018.After studying the clinical features of the disease in our study population,each patient was categorized according to the rEEC and AC based on data collected in his medical record during his first visit to our department. Then, we compared the sensitivities of these two criteria in the diagnosis of definite ALS.

Results: Our Tunisian cohort was characterized by a slower disease progression. The sensitivity of the AC (69.4%) was significantly higher than that of the rEEC (40.5%) (p < 0.001). When the clinical signs evolved for less than 6 months, the sensitivities were 61% for AC and 12% for rEEC (p < 0.001). After 24 months of disease progression, the sensitivities were 78.2% for AC and 69.1% for rEEC (p = 0.063). It was impossible to categorize seventeen patients by the two criteria.

Conclusion: Our study demonstrated that patients in AC are more sensitive than rEEC in the early diagnosis of ALS in our Tunisian cohort. However, this superiority is gradually reduced during the evolution of the disease.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Figure 1
Diagnostic categories for the entire cohort of ALS patients, according to the AC and rEEC.
Figure 2
Figure 2
Diagnostic categories for ALS patients with a duration of evolution of the disease from 0 to 6 months, according to the AC and rEEC.
Figure 3
Figure 3
Diagnostic categories for ALS patients with a duration of evolution of the disease from 7 to 12 months, according to the AC and rEEC.
Figure 4
Figure 4
Diagnostic categories of ALS patients with a duration of evolution of the disease from 12 to 24 months, according to the AC and rEEC.
Figure 5
Figure 5
Diagnostic categories of ALS patients with a duration of evolution of the disease exceeding 24 months, according to the AC and rEEC.
See this image and copyright information in PMC

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