Vizcarra-Escobar D, Cava-Prado L, Tipismana-Barbarán M
Hypnos Instituto del Sueño, Clínica San Felipe, Hospital Nacional Cayetano Heredia, Lima, Peru.
Rev Neurol. 2005;41(10):591-5.
In Peru up to recent years multiple sclerosis (MS) was considered a very rare disorder. AIM. To report clinical, epidemiological and ancillary test results of an MS cases series.
Description of a retrospective cohort of 55 patients studied in HNCH and a private neurological center in Lima between 1993-2004. Clinical records, laboratory and MRI tests were reviewed with Mc Donald's criteria.
There were 55 cases (36 women). Mean age was forty. 65% were born in Lima, 27% have foreign ancestor up to third generation. 42 cases were definite MS and 13 possible MS. The most frequent form of MS was RRMS (49.1%). Early symptoms were optic neuritis, motor and sensitive complaints; in the follow up cerebelar symptoms, increase of motor compromise and sphincteric disturbance were showed. Brain and spine MRI were positive in 27 cases and 17 cases respectively. VEP were abnormal in 53% of cases, just one case had cerebrospinal fluid (CSF) compatible with MS. Mode of EDSS was 6.5. Immunomodulators were used in 30% of cases. Survival at 10 and 20 years of disease were 87% and 45% respectively.
Our study shows than optic neuritis is an important early symptom and CSF study is commonly negative in patients with MS. Survival is shorter than other reports. Other features resembled previous international reports. To have foreign ancestors could be a risk factor for MS in this group.
在秘鲁,直到近年来多发性硬化症(MS)都被认为是一种非常罕见的疾病。目的:报告一组MS病例的临床、流行病学及辅助检查结果。
描述1993年至2004年间在秘鲁国立儿童医院(HNCH)和利马一家私立神经科中心研究的55例患者的回顾性队列。根据麦克唐纳标准对临床记录、实验室检查和MRI检查进行回顾。
共55例(36名女性)。平均年龄为40岁。65%出生于利马,27%有三代以内外国祖先。42例为确诊MS,13例为可能MS。最常见的MS类型是复发缓解型多发性硬化症(RRMS,49.1%)。早期症状为视神经炎、运动及感觉异常;随访中出现小脑症状、运动功能障碍加重及括约肌功能障碍。脑部和脊柱MRI分别在27例和17例中呈阳性。视觉诱发电位(VEP)在53%的病例中异常,仅1例脑脊液(CSF)符合MS表现。扩展残疾状态量表(EDSS)评分中位数为6.5。30%的病例使用了免疫调节剂。病程10年和20年的生存率分别为87%和45%。
我们的研究表明,视神经炎是MS的重要早期症状,CSF检查在MS患者中通常为阴性。生存率低于其他报告。其他特征与以往国际报告相似。有外国祖先可能是该组MS的一个危险因素。