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Abstract(s)
A Esclerose Múltipla é uma doença desmielinizante do Sistema Nervoso
Central que assume particular importância por afectar e incapacitar indivíduos
jovens.
Afecta em maior proporção mulheres e apresenta uma predisposição
genética.
A clínica apresentada é reflexo de lesões desmielinizantes encontradas
na substância branca do SNC, em vários locais, daí esta ser uma patologia que
apresente inúmeras formas clínicas.
A forma clínica mais comum é a surto-remissão.
Etiologicamente aponta-se para um fundo auto-imune e/ou infeccioso.
O diagnóstico assenta nos critérios de McDonald, suportado por exames
de imagem (RMN), análise do líquido cefalorraquidiano, potenciais evocados e
clínica.
O tratamento actualmente passa pelo uso de imunomoduladores e
imunosupressores.
A incapacidade clínica classifica-se através do EDSS, que varia de 0
(normalidade) até o grau máximo de 10 (morte por Esclerose Múltipla).
Quanto ao prognóstico, este é mais favorável para o sexo feminino,
doença com início em idade mais jovem e doença que se inicie com sintomas
sensitivos e disfunções dos nervos cranianos.
Neste trabalho efectuou-se um estudo retrospectivo documental numa
amostra de 40 doentes com Esclerose Múltipla do tipo surto-remissão e com diagnóstico há pelo menos três anos, seguidos na Consulta de Doenças
Desmielinizantes do Serviço de Neurologia do Centro Hospitalar Cova da Beira,
com o objectivo de efectuar o seu estudo descritivo.
Verificou-se nesta amostra que havia um predomínio de indivíduos do
sexo feminino (80%); que a média da idade no diagnóstico era, no geral, 32
anos, apresentando os homens uma idade média inferior à das mulheres na
amostra estudada; as formas de apresentação clínica mais comummente
encontradas neste estudo foram as alterações sensitivas, seguidas de neurite
óptica e alterações do tronco cerebral e cerebelo; esta amostra encontra-se
actualmente com um grau de disfunção ligeira ao apresentar um EDSS médio
de 1,78 e a medicação que foi prescrita no momento do diagnóstico com maior
frequência nestes casos foi o interferão β (1A e 1B).
Concluiu-se com este trabalho que na Esclerose Múltipla há relação
entre o número de anos de evolução da doença e o estado funcional do
doente; foi no entanto excluída qualquer relação entre o estado funcional dos
pacientes e a sua forma de apresentação clínica no momento do diagnóstico, o
seu sexo e a idade com que a doença é diagnosticada.
Multiple Sclerosis is a demyelinating disease of the Central Nervous System that assumes a particular role by affecting and disabling young people. It affects females in a larger proportion and presents a genetic predisposition. The clinical symptoms reflects the demyelinating lesions that are found in several locations of the white matter, of the Central Nervous System, therefore, it is a disease that can present itself in a variety of clinical forms. The commonest clinical form is relapsing-remitting Multiple Sclerosis. Auto-immune diseases and/or infections are possible etiological agents. The bases of the diagnosis are the McDonald criteria, supported by medical imaging test (Magnetic Resonance), liquor analysis, evoked potentials and clinical symptoms. Nowadays, imunomodulators and imunosupressors are the main treatment strategy. Disability can be classified through EDSS, that varies from 0 (normal exam) to 10 (death by Multiple Sclerosis). The prognosis is more favorable when the disease affects females and patients of a younger age, when there are initial sensitive symptoms and when the cranial nerves are affected at the diagnosis time. This research involved a retrospective study with a sample of 40 Relapsing-Remitting type of Multiple Sclerosis patients, with at least 3 years of diagnosis followed in the demyelinating diseases consultations in the Neurology Service of the Centro Hospitalar Cova da Beira. The aim of this study was to build a descriptive analysis. In this sample we found a predominance of females (80%); in general, the mean age of diagnosis was 32 years of age, being the men’s mean age of diagnosis inferior to the females; the most common presenting clinical forms found in this study were sensitive dysfunctions, followed by optical neuritis and brainstem and cerebelar dysfunctions. Having a medial EDSS of 1,78, this sample had a slight grade of dysfunction. When diagnosed, the most prescribed therapy was β Interferon (1A e 1B). In conclusion, Multiple Sclerosis is a disease with a relationship between the number of years of the evolution of the disease and the patient’s functional state. There was no relationship verified between the patient’s functional state with his clinical presentation at the time of diagnosis, or with their sex, or with their age of diagnosis.
Multiple Sclerosis is a demyelinating disease of the Central Nervous System that assumes a particular role by affecting and disabling young people. It affects females in a larger proportion and presents a genetic predisposition. The clinical symptoms reflects the demyelinating lesions that are found in several locations of the white matter, of the Central Nervous System, therefore, it is a disease that can present itself in a variety of clinical forms. The commonest clinical form is relapsing-remitting Multiple Sclerosis. Auto-immune diseases and/or infections are possible etiological agents. The bases of the diagnosis are the McDonald criteria, supported by medical imaging test (Magnetic Resonance), liquor analysis, evoked potentials and clinical symptoms. Nowadays, imunomodulators and imunosupressors are the main treatment strategy. Disability can be classified through EDSS, that varies from 0 (normal exam) to 10 (death by Multiple Sclerosis). The prognosis is more favorable when the disease affects females and patients of a younger age, when there are initial sensitive symptoms and when the cranial nerves are affected at the diagnosis time. This research involved a retrospective study with a sample of 40 Relapsing-Remitting type of Multiple Sclerosis patients, with at least 3 years of diagnosis followed in the demyelinating diseases consultations in the Neurology Service of the Centro Hospitalar Cova da Beira. The aim of this study was to build a descriptive analysis. In this sample we found a predominance of females (80%); in general, the mean age of diagnosis was 32 years of age, being the men’s mean age of diagnosis inferior to the females; the most common presenting clinical forms found in this study were sensitive dysfunctions, followed by optical neuritis and brainstem and cerebelar dysfunctions. Having a medial EDSS of 1,78, this sample had a slight grade of dysfunction. When diagnosed, the most prescribed therapy was β Interferon (1A e 1B). In conclusion, Multiple Sclerosis is a disease with a relationship between the number of years of the evolution of the disease and the patient’s functional state. There was no relationship verified between the patient’s functional state with his clinical presentation at the time of diagnosis, or with their sex, or with their age of diagnosis.
Description
Keywords
Esclerose múltipla Esclerose múltipla - Surto-remissão Esclerose múltipla - Critérios de McDonald Esclerose múltipla - Imunomoduladores Esclerose múltipla - Imunosupressores Esclerose múltipla - Prognóstico
Citation
Publisher
Universidade da Beira Interior