Abstract

TINOCO, Inês; FERREIRA, Joana Oliveira; RODRIGUES, João  and  ARENGA, Marta. Multiple sclerosis: a case report. Rev Port Med Geral Fam [online]. 2019, vol.35, n.3, pp.232-238. ISSN 2182-5173.  https://doi.org/10.32385/rpmgf.v35i3.12007.

Introduction: Multiple sclerosis is a demyelinating, inflammatory and degenerative disease. It may assume several clinical features, hampering the diagnosis, which should integrate a combination of the main symptoms, the clinical course and the results of more differentiated complementary exams. Case description: Young female, 38 years old, who consults her family doctor due to significant weight loss, tiredness, poly-phagia, and polyuria. Serious organic diseases were excluded. Multiple appointments followed this episode, where she presented unspecific symptoms (urinary incontinence, visual acuity impairment and muscle weakness, disequilibrium, and dizziness), which were confirmed in physical examination and though complementary exams. Because of her young age, and presenting multiple neurologic symptoms (visual, motor, sensitive and sphincter) we suspected of a demyelinating disease. Considering her family history (a similar disease in a sister), a Head CT was requested, and showed multiple hypodense lesions of the white matter, which sustained the diagnostic hypothesis, and that motivated the patient referral to Neurology. After a clinical evaluation and additional complementary tests, the diagnosis of Multiple Sclerosis was confirmed. Comments: The clinical course of this disease is unpredictable, which is associated to multiple and random lesions of the white matter of the Central Nervous System. This case report is an example of the diagnostic challenge that demyelinating diseases represent. These pathologies require a multidisciplinary articulation with Secondary Health Care, effective enough to allow an appropriate follow-up of such patients, and surpassing the inherent limitations of the Primary Health Care. This case, for its severity and impact on the patient’s quality of life, intends to make aware of the clinical suspicion for this pathology, allowing early diagnosis and treatment.

Keywords : Multiple sclerosis; Diagnosis; Case report.

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