Características clínicas e epidemiológicas de 146 pacientes com esclerose múltipla acompanhados na cidade de Fortaleza, CE, Brasil, entre os anos 1979 e 2010

Abstract

In order to study the natural history of Multiple Sclerosis (MS) in the state of Ceará, Brazil, the author retrospectively analyzes 146 patients diagnosed according to Poser and/or McDonald-2010 criteria. Cases and methods: biographical, clinical and para-clinical data collected on outpatient visits and at relapses. EDSS scores 4, 6 and 7 used as disability outcomes. Statistical software R (RKWard 0.5.3) used to perform descriptive analysis, Fisher exact test (p< 0,05) and time-to-the-event curves (Kaplan-Meier). Results: over 75 % of the patients followed for as long as 15 years; disease onset before 30 years of age in 47,9 %, with female sex preponderance (80.82 %). Patients with university education (33,5 %) are in high proportion when compared to the general population. Sensory, motor and sphincter complaints are the most common, in both initial and final examinations. Younger patients with relapsing-remitting MS took a longer time to reach EDSS 4. The proportion of benign MS cases was 4, 7 %. Annualized relapse rate was 0,6 . For most patients, the first two relapses took place in the initial three years of illness.Time between 1st. and 2nd relapses bears a positive relationship with time to reach EDSS 4, 6 and 7. Disease duration until death (8 cases , 5,4 %) was an average of 14,4 years. The prevalence of MS in the state of Ceará, Brazil, is estimated as 2,9 / 100.000 inhabitants. Conclusion: Clinical course of MS in the state of Ceará, Brazil (south latitudes between 2o 46’ and 7o 52’ ) is similar to that observed worldwide.