Protocolo de tratamiento del brote de esclerosis múltiple
- Alberte Woodward, M. 1
- López Dequidt. I.A. 1
- Prieto González, J.M.Ó 1
- 1 Servicio de Neurología, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, La Coruña, España
ISSN: 0304-5412
Ano de publicación: 2023
Título do exemplar: Enfermedades del sistema nervioso (IX): Enfermedades desmielinizantes
Serie: 13
Número: 78
Páxinas: 4649-4651
Tipo: Artigo
Outras publicacións en: Medicine: Programa de Formación Médica Continuada Acreditado
Resumo
Multiple sclerosis relapses consist of symptoms and signs caused by a new focal or multifocal inflammatory event in the central nervous system and must be distinguished from pseudo-relapses, related to the reappearance of residual symptoms from previous attacks, often in the context of fever or infection. Treating the relapse will hasten short-term recovery but will not modify the prognosis in the long-term. There are no differences between using high-dose oral or parenteral corticosteroids, but follow-up with a tapered oral regimen is not recommended. Mild symptoms (eg, localized sensory symptoms) can be managed on an outpatient basis or left untreated, but corticosteroid therapy is advised for disabling symptoms (eg, optic neuritis, ataxia, ophthalmoplegia, paresis). In the case of severe relapses and in the absence of a response to corticosteroids in the first week, a low threshold is advised so as to indicate plasma exchange, even if the diagnosis of the demyelinating syndrome is not fully established.
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