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Clinical characteristics of patients with multiple sclerosis defined in Cuba
INTRODUCTION. Since 1975 no studies have been done in Cuba defining the clinical characteristics of patients with multiple sclerosis (MS). OBJECTIVE. To describe the characteristics of a group of Cuban patients with definite clinical MS. MATERIAL AND METHODS. Fifty eight patients with definite clinical MS were studied (Poser et al), with normal motor (VCM) and sensory (VCS) conduction velocities. Tests were done on them: clinical scale (Scripps), incapacity (EDSS) and quality of life (Steps), together with various complementary tests. Each patient was classified according to the way in which the disease evolved. Also, the two commonest clinical types were compared and we applied the difference test between percentages of non-paired samples with an alfa level of 0.05.
RESULTS. Onset of the illness in most cases was before the age of 40 (86.1%), 75.9% were women and 82.8% were white. In 15.5% there was a family history of MS. In 25.9% there were psychiatric disorders and trigger factors (43.1%). The most frequent initial symptoms were: pyramidal (48.3%), sensorial (41.4%) and cerebellar (39.7%). Scripps scale scores were < 80 in 60.2%, in EDSS < 5 (61.9%) and in the Clinical Steps < 3 in 65.4%. Motor potentials (81.9%) somatosensory potentials (PESS) (72.3%) and magnetic resonance imaging (MRI) (76.4%) were the most abnormal results. Exacerbation-remission (ER) was the most frequent type of evolution (53.4%), generally affecting patients aged under 40 years old (p= 0.02), EDSS < 5 (64.4%), Scripps > 80 (61.2%), Steps < 3 (95.6%), pyramidal system involvement (58.5%), cerebellar (29.2%) and MRI abnormality (80%). The progressive primary form (PP) was the second most frequent (29.3%); 29.4% were under 40 years of age, had more marked changes in all functional systems (100%), degree of incapacity and quality of life (100%), PESS (92.5%); the urodynamic tests (58.85%) were less positive on MRI (54.5%) as compared with the ER form.
CONCLUSIONS.The differences found between the clinical forms ER and PP indicate that there is greater deterioration in the PP form, probably due to age and more cerebellar and spinal cord involvement
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