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Diagnóstico diferencial entre NMOSD y EM: un estudio retrospectivo basado en características clínicas y de imagen

Ya-Nan Ma¹, Qian Wang², Si-Rong Ma³

¹Department of Geriatrics and Specialty Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China.

Frontiers in neurology

|February 5, 2026

Resumen

Los trastornos del espectro de la neuromielitis óptica (NMOSD) y la esclerosis múltiple (EM) se presentan de manera diferente en cuanto a demografía, signos clínicos y localización de las lesiones. El diagnóstico temprano es crucial para un tratamiento eficaz y mejores resultados en estas enfermedades inflamatorias desmielinizantes del sistema nervioso central.

Área de la Ciencia:

Neuroinmunología
Neurología
Medicina Clínica

Sus antecedentes:

Los trastornos del espectro de la neuromielitis óptica (NMOSD) y la esclerosis múltiple (EM) son enfermedades desmielinizantes inflamatorias del sistema nervioso central con síntomas superpuestos.
El diagnóstico temprano preciso es un desafío pero es fundamental para un tratamiento eficaz y un mejor pronóstico del paciente.
La comprensión de las diferencias clínicas ayuda a diferenciar la NMOSD de la EM al inicio de la enfermedad.

Objetivo del estudio:

Comparar las características clínicas de NMOSD y EM para identificar factores diferenciadores clave.
Proporcionar información para que los médicos logren un diagnóstico temprano preciso y guíen las estrategias de tratamiento.
Mejorar los resultados de los pacientes facilitando intervenciones médicas oportunas y apropiadas.

Principales métodos:

Análisis retrospectivo de datos clínicos de pacientes con NMOSD y EM diagnosticados entre enero de 2018 y enero de 2022.
Inclusión de datos demográficos, historial médico, síntomas clínicos, hallazgos físicos, pruebas de laboratorio, imágenes y potenciales evocados.
Análisis estadístico de los datos recopilados para identificar diferencias significativas entre los dos grupos de enfermedades.

Principales resultados:

Los pacientes con NMOSD mostraron una mayor proporción de mujeres (86,2 % frente al 69,0 %) y una mayor frecuencia de enfermedades autoinmunes coexistentes.
Los pacientes con NMOSD presentaron síntomas iniciales más graves, signos neurológicos y mayor disfunción neurológica en fase aguda (puntuaciones EDSS más altas).
Se observaron diferencias distintivas en el líquido cefalorraquídeo, los marcadores serológicos y la localización de las lesiones: la EM predominantemente en el cerebro, la NMOSD en el nervio óptico y la médula espinal, con una afectación más extensa de la médula espinal en la NMOSD.

Conclusiones:

La NMOSD y la EM presentan diferencias significativas en demografía, presentación clínica, hallazgos de laboratorio y características de imagen.
Los pacientes con NMOSD son a menudo mayores al inicio, tienen una mayor proporción de mujeres y experimentan una mayor discapacidad y recaídas en comparación con la EM.
Distinguir entre NMOSD y EM a través de la evaluación clínica temprana es vital para implementar terapias dirigidas y mejorar el pronóstico del paciente.

Palabras clave:

EM NMOSD características clínicas diagnóstico diferencial pronóstico

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