Dados do Trabalho

Título

Multiple sclerosis in a 13-year-old girl.

RESUMO

Female, 13 years old. Asthma was mentioned as the only pre-existing disease. Reported that three months ago had started with paresthesia and loss of sensitivity in both lower limbs, but in the last month he remained only in the LLL, which culminated in the difficulty to extend and flexing the thigh, leg and left foot, this being the only reason for seeking the health service. Presented negative Brudzinski and Kering signs, isophotoreactive pupils and no cognitive alterations; grade II strength in the LLL, weak contractions, producing movement with elimination of gravity; and degree V of strength in the RLL, in addition with presence of varicose veins in the medial region of the thigh. Underwent complete blood count, EchoDoppler of the LLL and carotid arteries, echocardiogram and cerebrospinal fluid examination, speech-language analysis and pediatric evaluation – normal results. However, initial CT showed small hypodense area in left frontal lobe with an aspect unspecific to method. Brain MRI showed focal areas with signal alteration in white matter bilaterally, compromising periventricular, juxtacortical and optical radiation topography bilaterally, without contrast enhancement. Extending the scan, MRI of thoracic spine showed characteristic lesion of recent inflammatory activity, leading to sclerosing demyelinating disease (MS) hypothesis, which was confirmed by focal lesion identification with enhancement through the contrast at the T5 vertebral body. Pulse therapy with synthetic steroids was already started and this follow-up was necessary on an ongoing basis. Closed diagnosis of MS-with recurrent outbreak, re-presenting at two-month intervals. Etiology remained unknown.
According to DATASUS, state of SC is in 2nd place in relation to cases of disease in the southern region, having that, information pertinent to this situation in young patients, exposing the diagnostic protocol, can help more effective therapeutic outcomes. Therefore, rapid diagnostic, management and treatment of young patients with MS is increased through detailed anamnesis and neuroimaging. As a is chronic inflammatory disease of an autoimmune nature, adequate treatment increases and improves the patient's quality/expectation of life.
Knowledge of the epidemiological profile associated with a detailed neurological anamnesis supported by neuroimaging exams can reduce the interval between diagnostic confirmation and treatment, defining a more accurate and decisive prognosis.

Palavras Chave

Keywords: Young patient; Neuroimaging; Multiple sclerosis; pulse therapy.

Área

Neurologia Infantil