Document Type : Original Article


1 Multiple Sclerosis Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran

2 Department of Neurology, Shahid Sadoughi Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran

3 Department of Neurology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Isfahan Neurosciences Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

4 Department of Neurology, Booalicina Hospital, Mazandaran University of Medical Sciences, Sari, Iran

5 Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

6 Neurosciences Research Center, Tabriz University of Medical Sciences, Tabriz, Iran

7 Department of Neurology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

8 Clinical Development and Research Unit, Ghaem Hospital, Gilan University of Medical Sciences, Rasht, Iran

9 Department of Neurology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran

10 Neurology Research Center, Kerman University of Medical Sciences, Kerman, Iran

11 Department of Neurology, School of Medicine, Kashan University of Medical Sciences, Kashan, Iran

12 Department of Neurology, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran

13 Department of Neurology, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran


Background: Data on perioperative risk stratification in patients with multiple sclerosis (MS) are limited. In this regard, the present study was conducted to investigate Iranian specialists’ approach to surgical counseling for patients with MS (PwMS).
Methods: 21 MS specialists were asked about 11 case scenarios with different MS disease statuses, disease-modifying therapies (DMTs), and urgency of the operation. The reasons for refusing surgery or factors that have to be considered before surgery were studied.
Results: Overall, Fleiss Kappa was estimated to be 0.091 [95% confidence interval (CI): 0.090-0.093, P < 0.001] indicating a very poor level of agreement among responders.
Conclusion: PwMS face surgery for various reasons. Risk assessment of surgery, the effect of various drugs such as anesthetics and DMT on patients, as well as many other aspects of MS are issues challenging the practitioners. Clarifying the various dimensions of these issues requires further research.


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