Maria Fernanda Mendes

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

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.

Depressão na esclerose multipla forma remitente-recorrente

A possibilidade de correlacao entre depressao e esclerose multipla (EM) e conhecida ha muitos anos, porem os estudos de prevalencia nao sao conclusivos. No nosso meio a prevalencia deste sintoma na EM permanece desconhecida. O objetivo deste estudo e verificar a prevalencia da depressao em pacientes com EM, estudando a sua correlacao com a incapacidade funcional, o sexo, a idade e o tempo de doenca. Foram avaliados 84 pacientes com EM remitente-recorrente (EMRR). A depressao foi avaliada atraves da Escala de Beck e da Escala para Ansiedade e Depressao (HAD), e a incapacidade funcional pela Escala de Incapacidade Funcional Expandida (EDSS). A depressao estava presente em 17,9% e a ansiedade em 34,5% dos pacientes com EMRR. Os maiores escores das escalas de depressao correlacionaram-se com maior incapacidade funcional (p=0,0002), porem nao estao associados ao tempo de doenca, ao sexo ou a idade dos pacientes. Nossos dados indicam que a depressao e frequente nos pacientes com EM e sugerem haver correlacao entre a depressao e a incapacidade funcional.

Esclerose múltipla: adaptação transcultural e validação da escala modificada de impacto de fadiga

OBJECTIVE: The aim of this study is a cross-cultural adaptation and validation of the modified fatigue impact scale for Portuguese (MFIS- BR). METHOD: The MFIS was translated to Portuguese and retranslated to English. Two studies pilot had been carried through to be gotten the MFIS-BR, that was applied to 57 consecutive stable MS patients and 45 healthy controls. The retest was applied 30 days later. RESULTS: In the dwarfed statistics the internal consistency reability was similar to the original scale (0.74-0.86). The MFIS-BR showed be able to identify the different groups. Concerning the reliability the interclass correlation coefficient showed an excellent agreement (0.264-1.0). CONCLUSION: The MFIS-BR fills the criteria of applicability, sensibility witch are similar of the original version.

Fadiga e esclerose múltipla: estudo preliminar de 15 casos através de escalas de auto-avaliação

Fatigue is a common and disabiling symptom in multiple sclerosis but is poorly understood. Self-report measures are designed to capture the patients subjective sense of fatigue. We applied three scales in 15 patients with MS. Nine of them reported fatigue. The scores were high in all of these patients. We conclude that these scales must be used in assemble, to evaluate this symptom. Also, fatigue a very important symptom in multiple sclerosis patients.

Teste de destreza manual da caixa e blocos em indivíduos normais e em pacientes com esclerose múltipla

ABSTRACT - Recently new disease-modifying treatments for multiple sclerosis (MS) were introduced wich canchange the natural course of the disease. In clinical trials with these new agents the Expanded DisabilityStatus Scale (EDSS) is often used as a primary outcome instrument to measure neurological impairment anddisability. A number of limitations have been identified when using the EDSS, some of wich are because theEDSS is an ordinal scale that is heavily biased to locomotor function. In this study we applied the box andblock test of manual dexterity in normal subjects and relapsing-remitting MS patients. The results were that64.8% of the female and 80.7% of the male patients had significant changes on this task compared withnormal subjects, and as this test is easily applied and is sensitive in detecting upper extremity functionalability, we recommend its use in clinical trials to evaluate new drugs in MS patients.KEY WORDS: box and block test of manual dexterity, multiple sclerosis, disability scales.

Fadiga na forma remitente recorrente da esclerose múltipla

In 95 patients with the remitting-relapsing form of multiple sclerosis we investigated fatigue. All of them were evaluated with the Fatigue Severity Scale and we found it in 64 patients (67.4%). Gender, age, depression and fuctional incapacity was not predictive of fatigue occurrence, while anxiety and time of disease seems to be correlated with it. When we analysed the fatigue severity, a correlation between the EDSS and the increasing fatigue severity was found.

Reabilitação vestibular em pacientes com esclerose múltipla remitente-recorrente

Multiple sclerosis (MS) is a demyelinating, inflammatory illness, that attack the white matter of the central nervous system, and abnormal vestibular sensations (vertigo, disequilibrium) are frequent. The vestibular rehabilitation (VR) is determined by mechanisms of adaptations, neural substitutions and compensations. This study evaluated the improvement of the central or peripheral vertigo in patients with relapsing-remitting MS submitted to the VR (exercises of Cawthorne-Cooksey), through the scale of Berg and Dizziness Handicap Inventory (DHI). In this sample of 4 cases the VR, carried through in a period of 2 months, demonstrated the improvement in 3 patients according to the Berg scale and in 2 patients considering that of the DHI.

Recomendações quanto ao uso de drogas imunomoduladoras na esclerose múltipla: o consenso do BCTRIMS

After brief considerations about clinical course and diagnosis in multiple sclerosis, the members of the BCTRIMS present some recommendations for the use of the immunomodulatory drugs in the treatment of this disease.Apos breves consideracoes a respeito da evolucao clinica e diagnostico na esclerose multipla, os membros do BCTRIMS fazem algumas recomendacoes no uso de drogas imunomoduladoras no tratamento desta doenca.

Padronização da Multiple Sclerosis Functional Composite Measure (MSFC) na população brasileira

The Multiple Sclerosis Functional Composite Measure (MSFC) is an outcome measure in multiple sclerosis developed by USA National Multiple Sclerosis Society (1994), a three-part composite clinical measure - 9-Hole Peg Test, Timed 25-Foot Walk and PASAT. It should be multidimensional in order to reflect the principal ways MS affects an individual. The MSFC was applied in 91 Brazilian subjects and standardized to be use in MS centers.

Multiple sclerosis starting before the age of 18 years: the Brazilian experience

Multiple sclerosis (MS) starting in childhood and adolescence poses a challenge for diagnosis and management of the disease. The aim of the present study was to assess the characteristics of early onset MS in Brazilian patients. Methods Retrospective data collection from specialized MS units. Results From 20 MS units in 11 Brazilian states, 117 cases of MS starting before the age of 18 years were collected. These patients had an average of 10 years of disease duration, still typically with low disability and one relapse every 2.5 years. The mean age for disease onset was 13.7 years. Conclusion The present study introduces a large series of Brazilian cases of pediatric MS. Although some patients presented a very severe form of MS, on the whole the group of patients with MS starting in childhood or adolescence presented a relatively mild form of this disease in Brazil.