Esclerose múltipla: estudo descritivo de suas formas clínicas em 302 casos

Abstract

RESUMO -A esclerose múltipla é uma das causas mais comuns de incapacidade neurológica crônica em adultos jovens. Avaliamos, através de estudo retrospectivo, características epidemiológicas, formas de apresentação, manifestações clínicas, evolução e o grau de incapacitação física da esclerose múltipla em 302 pacientes. A média da idade dos pacientes foi 37,7 anos e a relação entre os gêneros foi 3,13F:1M. A média da idade no início da doença foi 29,6 anos. Duzentos e oitenta e três pacientes eram brancos (94%), 15 negros (5%) e 4 amarelos (1%). Duzentos e vinte pacientes (72%) apresentaram forma clínica tipo remitente-recorrente. Oitenta e dois pacientes (28%) apresentaram a forma progressiva (50% forma secundária e 50% forma primariamente progressiva). Os sintomas iniciais mais comuns foram sensitivos (31,7%) e ópticos (26,8%).Em relação aos sintomas evolutivos predominavam os sintomas piramidais (72,5%) e os medulares (64,9%). A média do escore do EDSS final foi 3,37 e a do NRS foi 85,17. O índice anual de surtos foi 0,45. Nossos achados coincidem com os da literatura mundial, e ressaltam que 60 pacientes (19,8%) apresentavam esclerose múltipla de forma benigna de valor prognóstico. PALAVRAS-CHAVES: esclerose múltipla, estudo descritivo, formas evolutivas. Multiple sclerosis: descriptive study of the clinical forms in 302 casesABSTRACT -Multiple sclerosis (MS) is one of the most common causes of chronic neurologic disability in young adults. We evaluate, through retrospective study, the epidemiological characteristics, the manifestations ways, the clinical manifestations, the evolution and the level of physical disability of MS in 302 patients. The average patients age was 37.7 and the relation between genders was 3.13F:1M. The average age at the beginning of MS was 29.6; 283 patients were white (94%), 15 patients were black (5%) and 4 patients were yellow; 220 patients (72%) presented relapsing-remmiting clinical form; 82 patients (28%) presented the progressive form (50% secondary form and 50% primarily progressive form). The most common initial symptoms were sensitive (31.7%) and optical (26.8%). The most common evolutive symptoms were pyramidal (72.5%) and of the spinal cord (64.9%). The average of the final EDSS was 3.37 and final NRS was 85.17. The index of the annual outbreak was 0.45. Our findings coincide to the ones in the worldwide literature, however it is important to point out that 60 patients (19.8%) presented benign MS of prognostic value.KEY WORDS: multiple sclerosis, descriptive study, evolutive forms.A esclerose múltipla (EM) é a desordem desmielinizante mais comum do sistema nervoso central (SNC), caracterizada por episódios repetidos de disfunção neurológica com remissão variável 1 .

Multiple sclerosis: report on 200 cases from Curitiba, Southern Brazil and comparison with other Brazilian series

“…However, using different criteria 18 , Moreira et al 16 found 19.8% of their patients with the benign form, compared to only 7% in our series 8 . The diagnosis of benign form is a retrospective one, and again the time of individual follow-up in different Services may account for such differences.…”

“…Neuromyelitis optica form has been reported to occur more frequently in African American and Asian type MS patients 16,17 . Papaiz-Alvarenga 12,13 , who had the series with the largest proportion of African Brazilian (31.8%) patients reported 5.6% with this clinical form, Leite et al 10 had 15.6%, whereas LanaPeixoto 11 , with 24 % of African Brazilian patients, reported a prevalence of 12% with Devic´s syndrome and suggested that his patients thus presented a clinical form more alike the Asian MS patients.…”

Validation of the "Six Step Spot Test" for gait among patients with multiple sclerosis in Brazil

“…After an evolution period of 10 years, 50% of these patients may be unfit to perform their professional and personal activities, thus resulting in individual and family suffering, associated with a great economic burden on society. These patients may be lost to the workforce, at the same time that they generate a high cost with their prolonged course of treatment [6][7][8][9] .…”

Assessment of patients with multiple sclerosis according to tests of the Multiple Sclerosis Functional Composite

“…The failure to ind a signi icant difference between the groups may suggest that the scale used is sensitive to the location of the demyelinating plaques, and that the evaluated subjects had greater impairment at the spinal cord level. Corroborating this hypothesis, Moreira et al (38) found in their study that the most common evolutionary symptoms in the relapsing-remitting form were spinal cord symptoms (75.9%). In addition, many MS patients tend to present more cognitive deterioration when they are in the progressive phase of the disease (39).…”