Multiple sclerosis and its clinical characteristics
Introduction
In recent times, increasing interest has been observed on the part of the Ecuadorian scientific community, regarding multiple sclerosis. In fact, in 2019 a group of specialists published a detailed epidemiological and clinical profile of this disease in Ecuador in the Ecuadorian magazine of neurology;being one of the widest reviews of the subject we currently have.
We must remember that EM is an autoimmune demyelinizing disease neurodegenerative chronic, which is considered the most frequent disease of this type in European adults;However, in Ecuador its prevalence is low according to figures provided by the first study carried out in the country during 2009 and subsequent investigations.
Developing
In Ecuador the prevalence of EM does not exceed 5 cases per 100.000 inhabitants, being Pichincha and Azuay the regions that have the highest concentration of cases. The researchers correlated this information with data provided by the National Institute of Statistics and Census, and noticed that in these provinces there is a higher density of Caucasian and mestizo population. In addition, it is important to emphasize that no patient with EM was identified that belongs to the indigenous population.
EM phenotypes in Ecuador
In Ecuador, similar to what is observed in the rest of the world, the EMRR is the most frequent type around 80% of cases. On the other hand, the EMPP presents a prevalence of 15% followed by the EMSP with 5%, which also corresponds to the global prevalence of the disease. EM can have very heterogeneous clinical manifestations, however several clinical phenotypes with common characteristics have been described:
- Multiple Multiple SCLEROSIS EMRR, in which symptoms occur in the form of outbreaks and alternate with periods of partial or total improvement.
- EMSP Progressive Secondary Multiple Sclerosis, presents a recurring pattern at the beginning of the disease, followed by a sustained increase in neurological disability.
- Progressive Primary Empp sclerosis, there is a progressive pattern since the beginning of the disease
Clinical features
Given the multiplicity of EM symptoms it is important to establish clinical manifestations in established phases. Ecuadorian researchers have found that 33.3% of patients debut with optical neuritis, 58.9% with spinal cord involvement and the remaining 6.9% with an affectation of the brain trunk.
Once the disease has been established, the most frequent clinical manifestations are: 79%motor symptoms, 64%sensitive symptoms, 67%oculomotor disorders, 46%fatigue and cognitive alteration 31%. Some of these figures coincide with other research carried out worldwide, and others do not, however it is possible that these discrepancies are due to the small size of the sample.
conclusion
Vitamin D insufficiency has been identified as one of the most important risk factors in the appearance of EM in the European and North American population. Although some studies show that in the Ecuadorian population the insufficiency of vitamin D is high, it has not been possible to establish a direct relationship between the number of cases and lack of vitamin.
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