Navegando por Palavras-chave "neuromyelitis optica"
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- ItemSomente MetadadadosNeuromyelitis optica in Brazil: a study on clinical and prognostic factors(Sage Publications Ltd, 2009-05-01) Bichuetti, D. B. [UNIFESP]; Oliveira, E. M. L. [UNIFESP]; Souza, N. A. [UNIFESP]; Rivero, R. L. M. [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objectives To describe the clinical characteristics of patients with relapsing neuromyelitis optica (NMO) from a tertiary care center in Brazil and compare the groups with normal and abnormal brain magnetic resonance imaging (MRI).Methods Retrospective review of 41 patients followed at the Neuroimmunology Clinic of the Federal University of São Paulo, Brazil, from 1994 to 2007.Results All patients had relapsing-remitting optic-spinal disease, long extending spinal cord lesions, and brain MRI not meeting Barkhof criteria for multiple sclerosis (MS), thus fulfilling the 1999 and 2006 Wingerchuck criteria for NMO. Mean follow-up time was 52 months; mean age of onset was 32.6 years. the mean relapse rate (RR) and progression index (PI) were 1.0 and 0.9, respectively. Twenty-four patients had brain lesions not compatible with MS on MRI, and there were no statistical differences on PI and RR between patients who had brain lesions and patients who did not. Incomplete recovery, but not the type of first relapse, correlated with a worse prognosis. Seventeen patients were tested for NMO-IgG (anti-aquaporin-4 antibody) with 41% positivity.Conclusions in this series, we did not find a statistical difference of disease progression between patients with and without brain lesions, suggesting that the presence of brain abnormalities is not a marker of disease severity. Multiple Sclerosis 2009; 15: 613-619. http://msj.sagepub.com
- ItemSomente MetadadadosNeuromyelitis Optica With Onset in Childhood and Adolescence(Elsevier B.V., 2014-01-01) Fragoso, Yara Dadalti; Ferreira, Maria L. B.; Oliveira, Enedina M. L. [UNIFESP]; Domingues, Renan B.; Ribeiro, Taysa A. G. J.; Brooks, Joseph B. B.; Claudino, Rinaldo; Netto, Jussara M. K.; Gomes, Sidney; Adoni, Tarso; Carneiro, Denise S. D.; Fonseca, Daiana R. P.; Fragomeni, Manuela O. [UNIFESP]; Oliveira, Francisco T. M.; Oliveira, Celso L. S.; Saldanha, Patricia C. O.; Souza, Jorge M. B.; Univ Metropolitana Santos; Hosp Restauracao; Universidade Federal de São Paulo (UNIFESP); Santa Casa Vitoria; Universidade Federal de Goiás (UFG); Universidade Federal de Santa Catarina (UFSC); Universidade Federal do Rio de Janeiro (UFRJ); Hosp Beneficencia Portuguesa; Hosp Paulistano; Hosp Sirio LibanesBACKGROUND: Neuromyelitis optica with onset before the age of 18 years is a relatively rare, yet potentially devastating condition. the objective of the present study was to contribute to the study of early-onset neuromyelitis optica with a case series. PATIENTS: Data were collected from medical records of Brazilian neurologists caring for patients with neuromyelitis optica occurring in childhood and adolescence. RESULTS: Twenty-nine patients with neuromyelitis optica occurring before the age of 18 years and fulfilling the diagnostic criteria were identified. the average age at disease onset was 13 years and the patients had had an average disease duration of 6 years. the expanded disability scale score at the latest consultation was, on average, 4.7, and one patient had died from the disease. the 29 patients had had an average 4.5 relapses during the disease, accounting for 0.75 relapses per year, irrespective of the medication used. All patients were using one or more of the following medications: azathioprine, prednisone, immunoglobulin, and glatiramer acetate. CONCLUSIONS: Neuromyelitis optica with onset in childhood and adolescence is a poorly understood condition that is often disabling and difficult to manage.
- ItemAcesso aberto (Open Access)Neuromyelitis optica: brain abnormalities in a Brazilian cohort(Academia Brasileira de Neurologia - ABNEURO, 2008-03-01) Bichuetti, Denis Bernardi [UNIFESP]; Rivero, René Leandro Magalhães [UNIFESP]; Oliveira, Daniel May [UNIFESP]; Souza, Nilton Amorin de [UNIFESP]; Abdala, Nitamar [UNIFESP]; Oliveira, Enedina Maria Lobato de [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Schering do BrasilNeuromyelitis optica (NMO) is a demyelinating disease consisting of relapsing-remitting optic neuritis and myelitis with a more severe course than Multiple Sclerosis. Recently, it has been shown that almost 50% of patients with NMO can have brain magnetic resonance imaging (MRI) abnormalities. We report on six Brazilian patients with NMO, fulfilling the 1999 Wingerchuck criteria for this disease, with abnormal brain MRI and discuss their clinical and radiological features.
- ItemAcesso aberto (Open Access)Patients with neuromyelitis optica have a more severe disease than patients with relapsingremitting multiple sclerosis, including higher risk of dying of a demyelinating disease(Academia Brasileira de Neurologia - ABNEURO, 2013-05-01) Bichuetti, Denis Bernardi [UNIFESP]; Oliveira, Enedina Maria Lobato de [UNIFESP]; Souza, Nilton Amorin de; Tintoré, Mar; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Hospital Universitari Vall d?Hebron Center d?Esclerosi Múltiple de Catalunya-CEMcatAlthough neuromyelitis optica (NMO) is known to be a more severe disease than relapsing-remitting multiple sclerosis (RRMS), few studies comparing both conditions in a single center have been done.Methods: Comparison of our previously published cohort of 41 NMO patients with 177 RRMS patients followed in the same center, from 1994 to 2007. Results: Mean age of onset was 32.6 for NMO and 30.2 for RRMS (p=0.2062) with mean disease duration of 7.4 years for NMO and 10.3 years for RRMS. Patients with NMO had a higher annualized relapse rate (1.0 versus 0.8, p=0.0013) and progression index (0.9 versus 0.6, p≪0.0001), with more patients reaching expanded disability status scale (EDSS) 6.0 (39 versus 17%, p=0.0036). The odds ratio for reaching EDSS 6.0 and being deceased due to NMO in comparison to RRMS were, respectively, 3.14 and 12.15. Conclusion: Patients with NMO have a more severe disease than patients with RRMS, including higher risk of dying of a demyelinating disease.
- ItemAcesso aberto (Open Access)The profile of patients followed at the Neuroimmunology Clinic at UNIFESP: 20 years analysis(Assoc Arquivos Neuro- Psiquiatria, 2015-04-01) Bichuetti, Denis Bernardi [UNIFESP]; Falcao, Alessandra Billi [UNIFESP]; Boulos, Fernanda de Castro [UNIFESP]; Morais, Marilia Mamprim de [UNIFESP]; Campos Lotti, Claudia Beatriz de [UNIFESP]; Fragomeni, Manuela de Oliveira [UNIFESP]; Campos, Maria Fernanda [UNIFESP]; Souza, Nilton Amorim de [UNIFESP]; Lobato Oliveira, Enedina Maria [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Objective: To describe the clinical activities at the Neuroimmunology Clinic of the Universidade Federal de São Paulo (UNIFESP) from 1994 to 2013. Method: the final diagnosis of all patients that attended the center was reviewed and established upon specific guidelines for each disease. the number of total appointments and extra clinical activities (reports and prescriptions) were also analyzed, as are part of routine activities. Results: 1,599 patients attended the Clinic from 1994 to 2013: 816 with multiple sclerosis (MS), 172 with clinical isolated syndromes, 178 with neuromyelitis optica (NMO), 216 with other demyelinating disease, 20 with metabolic disorder, 42 with a vascular disease and 155 with other or undetermined diagnosis. A mean 219 outpatient visits and 65 extra clinical activities were performed monthly. Conclusion: We identified that 15% of patients seen have NMO. As patients with NMO have a more severe disease than MS, this data may be important for planning local health care policies.
- ItemSomente MetadadadosWhite matter spectroscopy in neuromyelitis optica A case control study(Dr Dietrich Steinkopff Verlag, 2008-12-01) Bichuetti, Denis Bernardi [UNIFESP]; Magalhaes Rivero, Rene Leandro [UNIFESP]; Lobato de Oliveira, Enedina Maria [UNIFESP]; Oliveira, Daniel May [UNIFESP]; Souza, Nilton Amorin de [UNIFESP]; Nogueira, Roberto Gomes [UNIFESP]; Abdala, Nitamar [UNIFESP]; Gabbai, Alberto Alain [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background Naa/Cr ratio in normal appearing white matter (NAWM) of patients with multiple sclerosis (MS) is altered beyond plaques, suggesting early axonal loss, and correlates to clinical disability. Brain lesions not typical of MS have been described in Neuromyelitis optica (NMO), and correspond to brain aquaporin-4 channel sites, but the evaluation of Naa/Cr ratio in NAWM of patients with NMO and its association to the presence of brain lesions and clinical disability have not been described. Objectives To evaluate the Naa/Cr of normal appearing white matter (NAWM) in 16 patients with NMO compared to healthy controls. Methods We performed brain magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) of 16 patients with NMO and compared to age matched healthy controls. Results NAWM Naa/Cr did not show statistical difference among patients and controls, neither between patients that had normal brain MRI and atypical brain lesions. Conclusion NAWM was found to have a normal Naa/Cr in patients with NMO, reinforcing the concept that the white matter is not primarily affected in this disease.