STUDIES ON THE NATURAL HISTORY OF MULTIPLE SCLEROSIS 6. Clinical and Laboratory Findings at First Diagnosis

Abstract

ABSTKACT Signs, symptoms, and laboratory findings were presented to describe an early bout of multiple sclerosis (&IS). Data were derived from ITS.Army hospitalizations during the World War I1 period. For 293 men (group A), there had been previous bouts before the one for which they were hospitalized in the Army, whereas for 234 men (group B), this Army hospital bout was the onset bout. Median duration of this Army diagnostic bout was 2 months from onset to neurologic examination. Signs found at neurologic examination were classified into 8 functional systcms : pyramidal, cerebellar, brain stem, sensory, bowel and bladder, visual, cerebral, and miscellaneous; symptoms were categorized into 8 equivalent groups. Over-all dysfunction was graded according to the Disability Status Scale. There was a moderate degree of concordance between signs and symptoms of each type. In cvcry aspect save one, the group A and group B cases were indistinguishable; visual dysfunction was somewhat more prevalent in group A. Involvement at examination was most common in pyramidal (85 %), cerehellar (77 %), brain stem (73 %), and sensory (55 %); less common were bowel and bladder (23 %), visual ( 3 4 % ) , cerebral (mostly mood change) (21 yo), and miscellaneous signs (15 Yo). Each functional system tended to correlate with over-all disability in both frequency and severity of involvement. When symptoms were distributed by limbs affected, motor and coordination complaints showed a predilection for lower limbs and a tendency to symmetry, whereas sensory complaints were almost equally common in each body part. Cerebrospinal fluid findings were in accord with those of most series. ThereThis study is part of a program of medical follow-up studies organized by the NAS-NRC at the request of the Veterans Administration, the Department of Defense, and the Public Health Service. 2'

Esclerose múltipla: análise clínica e evolutiva de 214 casos

“…A análise da freqüência dos sintomas iniciais na EM da nossa casuística, comparativamente às estrangeiras, revela: semelhança quanto a série de Kurtzke 13 , para sintomas piramidais e visuais; com a de Bauer 3 , para sintomas piramidais e medulares; e com a de Kuroiwa 12 , nos itens relativos ao tronco cerebral e cerebelo. Nos demais, há diferenças, com ênfase maior para a baixa freqüência, em relação a todas as séries, de sintomas sensitivos na nossa casuística (Tabela 1).…”

Avaliação dos potenciais evocados auditivos do tronco encefálico na esclerose múltipla

“…Doutourando em Otorrinolaringologia EPM-UNIFESP; 2 Professor Adjunto dos Departamentos de Neurologia e Oftalmologia da UFMG; 3 Professor Associado Livre Docente da Disciplina de Otoneurologia da EPM-UNIFESP; 4 Especialista em Distúrbios da Comunicação Humana -EPM-UNIFESP. Os potenciais evocados representam respostas elétricas do sistema nervoso a um estímulo externo 1 .…”

“…A esclerose múltipla (EM) é o tipo mais comum de doença desmielinizante 3 , sendo predominantemente encontrada em adultos jovens, tendo curso lento e progressivo, com períodos de exarcebação e remissão dos sintomas específicos. São freqüentes alterações no nervo óptico, medula espinhal, tronco encefálico e regiões periventriculares.…”

Ressonância magnética na esclerose múltipla: análise de 270 casos

“…Esclerose múltipla (EM) é a mais comum das doenças desmielinizantes 1,2 , sendo caracterizada pela localização de múltiplas placas de desmielinização na substância branca encefálica e medular. Estas lesões causam sinais e sintomas neurológicos intermitentes que, com a evolução da doença, podem agravar-se progressivamente.…”