RESUMO
La esclerosis múltiple es la enfermedad autoinmune que afecta al sistema nervioso central más frecuente en sujetos de entre 20-50 años, y es la principal causa de discapacidad en este grupo. Su cuadro clínico suele ser de cuadros agudos neurológicos con remisiones posteriores y en algunos casos suelen ser progresivos hasta la muerte. El diagnóstico se basa en el cuadro clínico y se apoya en la evidencia de lesiones en resonancia magnética diseminadas en tiempo y espacio, los múltiples tratamientos en la actualidad no curan la enfermedad pero logran suprimir en gran numero la cantidad de brotes. Realizamos esta revisión con el objetivo de mostrar el espectro general de esta amplia enfermedad con la idea de que sea de ayuda a médicos y estudiantes que no estén familiarizados con esta patología que es cada vez más frecuente en nuestro país.
Multiple sclerosis is an autoimmune disease that affects the central nervous system, most common in young people aged 20-50 years. It is the leading cause of disability in this group. The clinical course is usually characterized by severe neurological afflictions followed by remissions and in some cases tend to be progressive to death. The diagnosis is based on clinical symptoms and is supported by the evidence of MRI lesions disseminated in time and space, multiple treatments are currently incapable of curing the disease but they are able to suppress outbreaks in great measure. This review was made with the mere objective to demonstrate the general spectrum of this wide illness with the idea that it is helpful to physicians and students who are not familiar with the disease that is becoming increasingly common in our country.
RESUMO
BACKGROUND: Moyamoya disease is a rare idiopathic non-atherosclerotic, non-inflammatory and non-amyloid cerebrovascular disease characterized by stenosis and progressive occlusion of the internal carotid artery and its branches. Upon panangiography, this abnormality is typically visualized as a cigarette smoke-like pattern due to formation of new collateral vessels. The highest incidence occurs in Asia, principally affecting women. This case report describes the characteristics of these patients and the way to diagnose and treat them. CLINICAL CASE: A 43-year-old man with a history of chronic headache, subarachnoid hemorrhage and tonic clonic seizures; because of his age he was programmed to the young patient study protocol and so he underwent some studies like angiography, angiographic resonance and transcranial Doppler, these exams revealed a bilateral stenosis of the internal carotid arteries and its branches. DISCUSSION: The prognosis of these patients is unfavorable when the disease begins in childhood. Since conservative treatment may not be long-term useful, surgery should be considered in patients with Moyamoya disease. The use of transcranial Doppler is recommended in patients with these clinical features as an initial diagnostic exam.