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El retraso en el diagnóstico y el tratamiento de los pacientes con esclerosis múltiple: un estudio multicéntrico
Salma Ragab1, Basem Hamdy Fouda2, Abdallah-Almamun Sarhan3
1Neurology Department, Faculty of Medicine, Kafrelsheikh University, Kafr El-Sheikh, Egypt.
BMC neurology
|September 2, 2025
Resumen
El diagnóstico tardío de la esclerosis múltiple (EM) está relacionado con factores como la edad, el tipo de enfermedad y los síntomas iniciales. Este retraso empeora significativamente la discapacidad de la EM y los resultados del paciente.
Área de la Ciencia:
- Neurología
- Investigación clínica
Sus antecedentes:
- La esclerosis múltiple (EM) es una enfermedad neurológica crónica de presentación variable.
- El diagnóstico y el tratamiento oportunos son cruciales para controlar la progresión de la EM y los resultados del paciente.
Objetivo del estudio:
- Identificar los factores que contribuyen al retraso en el diagnóstico y el tratamiento en pacientes con esclerosis múltiple (EM).
- Evaluar el impacto de los retrasos diagnósticos y terapéuticos en los resultados de la enfermedad de EM.
Principales métodos:
- Un estudio multicéntrico observacional de cohorte en el que participaron 239 pacientes con EM en cuatro ciudades egipcias.
- Utilizó la Escala de Gravedad de Esclerosis Múltiple (MSSS) y la Escala de Estatus de Discapacidad Expandida (EDSS) para la evaluación de la gravedad y la discapacidad.
- Tiempo de retraso de diagnóstico calculado desde el inicio de los síntomas hasta el diagnóstico preciso.
Principales resultados:
- El diagnóstico retrasado se asoció con EM primaria progresiva (EMP), síntomas sensoriales en el inicio y edad más temprana.
- Buscar atención inicial de oftalmólogos y neurólogos prolongó el diagnóstico.
- Se encontró una correlación positiva significativa entre el retraso en el diagnóstico y el aumento de la gravedad de la EM (EDSS, MSSS, PI).
- El retraso en el diagnóstico, la EDSS en el momento del diagnóstico y la duración de la enfermedad predijeron de forma independiente la gravedad de la EM.
Conclusiones:
- Factores como la edad al inicio, retrasos en la derivación de otras especialidades y síntomas sensoriales iniciales prolongan el diagnóstico de EM.
- El diagnóstico y el tratamiento retrasados de la EM conducen a un aumento de la discapacidad y a peores resultados funcionales.
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