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Academia Mexicana de Neurología, A.C.

2015, Número 3

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Rev Mex Neuroci 2015; 16 (3)


Síntomas transitorios en esclerosis múltiple

Treviño-Frenk I, Flores J, Vidaltamayo R

Idioma: Español
Referencias bibliográficas: 44
Paginas: 27-38
Archivo PDF: 231.21 Kb.


RESUMEN

La esclerosis múltiple (EM) produce lesiones multifocales desmielinizantes que producen una gran diversidad de síntomas transitorios o progresivos con discapacidad irreversible. La desmielinización produce una alteración en la función neurológica debido a la pérdida de las funciones aislantes y de capacidad de aumentar la velocidad de conducción nerviosa de la mielina. Los brotes típicos de EM consisten en periodos de semanas o meses de síntomas neurológicos nuevos que pueden o no evolucionar hacia la cronicidad cuando la recuperación no es completa. Muchos pacientes presentan eventos más breves y transitorios que pueden durar segundos o minutos y que no se explican por la presencia de nuevas placas de desmielinización. Los recaídas sintomáticas o brotes se manifiestan como pérdida de funciones fisiológicas, lo cual produce síntomas tanto positivos como negativos, tales como paresia, hipoestesia, pérdida visual, diplopía o ataxia. Los síntomas positivos más frecuentes manifestados por pacientes con EM son parestesias, prurito paroxístico, neuralgia del trigémino, fosfenos, espasmos tónicos, mioquimias faciales y signo de Lhermitte. Estas manifestaciones son debidas a la hiperexcitabilidad de los axones desprovistos de mielina, en los cuales se generan impulsos eléctricos ectópicos, descargas axonales sincrónicas, irradiación de impulsos, interacciones efápticas y un aumento de la mecanosensibilidad.


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