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1.
Rev. neuro-psiquiatr. (Impr.) ; 85(2): 95-106, abr.-jun 2022. tab
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1409923

ABSTRACT

RESUMEN El uso de la resonancia magnética (RM) en el diagnóstico y seguimiento de pacientes con esclerosis múltiple (EM) ha optimizado el cuidado de los pacientes afectados. Diversos grupos internacionales de trabajo han intentado clarificar y normatizar el uso global de la RM pero, en muchas ocasiones, se extrapolan datos de otras regiones que no contemplan la realidad de cada lugar o son difíciles de implementar. Objetivo: Consensuar aspectos relacionados con el uso de RM en el diagnóstico y seguimiento de pacientes con EM en el Perú. Material y Métodos: Un grupo de expertos peruanos, conformado por neurólogos y radiólogos, condujo la elaboración del consenso mediante metodología de ronda de encuestas a la distancia. Resultados: Las recomendaciones, basadas en la evidencia publicada y en el criterio de los expertos, enfocaron tanto el rol de las técnicas convencionales de RM como el de la medición de la atrofia cerebral en pacientes con EM al momento del diagnóstico y durante el periodo de seguimiento. Conclusiones: Las recomendaciones del consenso podrán potencialmente homogenizar y optimizar el cuidado y seguimiento de pacientes con EM en nuestro país.


SUMMARY The use of Magnetic Resonance Imaging (MRI) in the diagnosis and follow-up of patients with Multiple Sclerosis (MS) has optimized the care of the affected patients. Several international working groups have tried to clarify and standardize the global use of MRI but, on many occasions, data are extrapolated from other regions, do not contemplate local realities or are difficult to implement. Objective: To reach a consensus on aspects related to the use of MRI in the diagnosis and follow-up of patients with MS in Peru. Material and Methods: A group of Peruvian experts (neurologists and radiologists) worked on the elaboration of the consensus using a remote survey round methodology. Results: The recommendations, established on the basis of published evidence and on the experts' criteria, focused on the role of both, the conventional MRI techniques and the measurement of brain atrophy in MS patients both at the time of diagnosis and during the follow-up period Conclusions: The consensual recommendations could potentially assist in the standardization and optimization of the care and follow-up of patients with MS in our country.

2.
Heliyon ; 7(10): e08069, 2021 Oct.
Article in English | MEDLINE | ID: mdl-34765756

ABSTRACT

BACKGROUND: MS is unpredictable regarding clinical symptoms; however, certain symptoms represent the preferred localization of white matter lesions such as brainstem, spinal cord; or optic nerve. OBJECTIVES: To investigate the epidemiological, clinical, and imaging characteristics of MS patients in a national referral center in Peru, and to evaluate whether the type of symptom at onset relates with the time to making an MS diagnosis. METHODS: Retrospective study of MS patients at the Instituto Nacional de Ciencias Neurológicas between January 2010 and December 2018. Four different syndromes were selected for analysis as symptom onset (optic neuritis, brainstem syndrome, myelitis, and others). RESULTS: we identified 268 patients for whom a diagnosis of MS had been given; after excluding misdiagnosed patients (33 Neuromyelitis optica), lost or incomplete records, 121 patients were included. The majority of patients (46.6%) were born in Lima. Female to male ratio was 1.37 to 1, mean age at diagnosis was 31 years. At onset, myelitis was present in 35% of RRMS patients, followed by brainstem syndrome (25%) and optic neuritis (18%). Brainstem syndrome was statistically significant predictor for earlier diagnosis (adjusted HR: 2.09; p = 0.015). CONCLUSION: Brainstem syndrome as an initial presentation of MS in Peru is related to an earlier diagnosis.

3.
Rev Peru Med Exp Salud Publica ; 38(1): 89-94, 2021.
Article in Spanish, English | MEDLINE | ID: mdl-34190931

ABSTRACT

The objective of the study was to describe the clinical characteristics, treatment response and possible associated factors of patients with Guillain-Barré syndrome at the National Institute of Neurological Sciences. A descriptive study on hospital discharges was conducted during the period 2017-2019. Treatment response was evaluated based on Hughes' disability scale. From 31 patients 61.3% were males and the mean age was 50 years. At admission, 87.1% of patients were on grade 3 or 4 of Hughes scale, most of them with axonal compromise which was associated to disability. Only 22 patients received plasma exchange; 6 months thereafter, 90.9% of patients decreased by at least one degree in Hughes scale and 42.8% were left without disability. In conclusion, a male and axonal subtype predominance was found, been the latter associated to disability.


El objetivo del estudio fue describir las características clínicas, la respuesta al tratamiento y posibles factores asociados de los pacientes con síndrome de Guillain Barré en el Instituto Nacional de Ciencias Neurológicas. Se realizó un estudio descriptivo sobre egresos hospitalarios durante el periodo 2017-2019. La respuesta al tratamiento se evaluó mediante la escala de discapacidad de Hughes. De los 31 pacientes el 61,3% eran varones, y la edad promedio fue de 50 años. Al ingreso, el 87,1% de pacientes se encontraban en el grado 3 o 4 de la escala de Hughes, la mayoría con compromiso axonal, el cual estuvo asociado a discapacidad. Solo 22 pacientes recibieron recambio plasmático; luego de seis meses el 90,9% disminuyó al menos en un grado en la escala de Hughes y el 42,8% quedaron sin discapacidad. En conclusión, se encontró un predominio del sexo masculino y del compromiso axonal, este último asociado a discapacidad.


Subject(s)
Guillain-Barre Syndrome , Plasma Exchange , Guillain-Barre Syndrome/therapy , Hospitalization , Humans , Male , Middle Aged
4.
Rev. peru. med. exp. salud publica ; 38(1): 89-94, ene-mar 2021. tab
Article in Spanish | LILACS | ID: biblio-1280551

ABSTRACT

RESUMEN El objetivo del estudio fue describir las características clínicas, la respuesta al tratamiento y posibles factores asociados de los pacientes con síndrome de Guillain Barré en el Instituto Nacional de Ciencias Neurológicas. Se realizó un estudio descriptivo sobre egresos hospitalarios durante el periodo 2017-2019. La respuesta al tratamiento se evaluó mediante la escala de discapacidad de Hughes. De los 31 pacientes el 61,3% eran varones, y la edad promedio fue de 50 años. Al ingreso, el 87,1% de pacientes se encontraban en el grado 3 o 4 de la escala de Hughes, la mayoría con compromiso axonal, el cual estuvo asociado a discapacidad. Solo 22 pacientes recibieron recambio plasmático; luego de seis meses el 90,9% disminuyó al menos en un grado en la escala de Hughes y el 42,8% quedaron sin discapacidad. En conclusión, se encontró un predominio del sexo masculino y del compromiso axonal, este último asociado a discapacidad.


ABSTRACT The objective of the study was to describe the clinical characteristics, treatment response and possible associated factors of patients with Guillain-Barré syndrome at the National Institute of Neurological Sciences. A descriptive study on hospital discharges was conducted during the period 2017-2019. Treatment response was evaluated based on Hughes' disability scale. From 31 patients 61.3% were males and the mean age was 50 years. At admission, 87.1% of patients were on grade 3 or 4 of Hughes scale, most of them with axonal compromise which was associated to disability. Only 22 patients received plasma exchange; 6 months thereafter, 90.9% of patients decreased by at least one degree in Hughes scale and 42.8% were left without disability. In conclusion, a male and axonal subtype predominance was found, been the latter associated to disability.


Subject(s)
Humans , Male , Female , Patients , Therapeutics , Guillain-Barre Syndrome , Cerebrospinal Fluid , Plasmapheresis , Giant Axonal Neuropathy , Hospitals
5.
Rev. peru. med. exp. salud publica ; 38(1): 89-94, ene-mar 2021. tab
Article in Spanish | LILACS | ID: biblio-1280587

ABSTRACT

RESUMEN El objetivo del estudio fue describir las características clínicas, la respuesta al tratamiento y posibles factores asociados de los pacientes con síndrome de Guillain Barré en el Instituto Nacional de Ciencias Neurológicas. Se realizó un estudio descriptivo sobre egresos hospitalarios durante el periodo 2017-2019. La respuesta al tratamiento se evaluó mediante la escala de discapacidad de Hughes. De los 31 pacientes el 61,3% eran varones, y la edad promedio fue de 50 años. Al ingreso, el 87,1% de pacientes se encontraban en el grado 3 o 4 de la escala de Hughes, la mayoría con compromiso axonal, el cual estuvo asociado a discapacidad. Solo 22 pacientes recibieron recambio plasmático; luego de seis meses el 90,9% disminuyó al menos en un grado en la escala de Hughes y el 42,8% quedaron sin discapacidad. En conclusión, se encontró un predominio del sexo masculino y del compromiso axonal, este último asociado a discapacidad.


ABSTRACT The objective of the study was to describe the clinical characteristics, treatment response and possible associated factors of patients with Guillain-Barré syndrome at the National Institute of Neurological Sciences. A descriptive study on hospital discharges was conducted during the period 2017-2019. Treatment response was evaluated based on Hughes' disability scale. From 31 patients 61.3% were males and the mean age was 50 years. At admission, 87.1% of patients were on grade 3 or 4 of Hughes scale, most of them with axonal compromise which was associated to disability. Only 22 patients received plasma exchange; 6 months thereafter, 90.9% of patients decreased by at least one degree in Hughes scale and 42.8% were left without disability. In conclusion, a male and axonal subtype predominance was found, been the latter associated to disability.


Subject(s)
Humans , Male , Female , Patients , Plasma Exchange , Therapeutics , Guillain-Barre Syndrome , Cerebrospinal Fluid , Plasmapheresis , Giant Axonal Neuropathy
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