神経学的障害

The Clinical and Epidemiological Spectrum of Multiple Sclerosis in Quito, Ecuador

Abstract

Edgar Patricio Correa Diaz, Angelica Ortiz Yepez, Germaine Torres Herran, Maria Eugenia Buestan Zumba, Braulio Martinez Burbano, Victor Paredes Gonzales, Jacome Sanchez Carolina, Vanessa Vasconez Davalos, Juan Jose Zambrano Godoy, Estefania Flores Cordova, Evelyn Benalcazar, Josette Barros and Carla Acosta Vasquez

Background: Multiple sclerosis (MS) is a chronic, degenerative autoimmune inflammatory disease leading to demyelination and axonal damage to the brain and spinal cord. This entity is low prevalence in Ecuador, and so far there are few reports regarding this disease. Objective: To establish clinical and epidemiological characteristics of MS patients at Hospital Carlos Andrade Marín (HCAM) in the city of Quito, and to compare these findings with the reports published worldwide. Methods: Using the McDonald criteria for diagnosis of MS 2010, we retrospectively reviewed the medical records of patients with MS who came to HCAM in Quito from January 2005 to December 2014. Degree of disability information, as well as clinical and demographic data was recorded. Then, a descriptive analysis of the data was performed. Outcomes: 102 cases of multiple sclerosis were identified, the majority of which were female (female to male ratio of 2.2:1). The average age of this population was 39.6 years (SD +/-11.6), and the average age of symptom onset was 32 years (SD +/-11.1). The majority of cases corresponded to the recurrent remittent multiple sclerosis (RRMS) type at 93%. Only 3 were progressive MS cases and 8 cases represented clinically isolated syndromes (CIS). Among the initial clinical manifestations, optical neuritis (ON) was present in 33% of cases, acute myelitis (AM) in 60% and 12.7% of patients debuted with brainstem manifestations. Motor, visual and sensory symptoms were the most common clinical manifestations established (79.67% and 63.7%, respectively). Cognitive and neuropsychiatric disorders were also common (56% and 37%, respectively). The average disability measured by The Expanded Disability Status Scale (EDSS) was 3.7. Conclusion: This is the first descriptive study of a cohort of patients with MS from the City of Quito, Ecuador. The clinical and epidemiological characteristics of this cohort did not differ from those described worldwide.