Towards establishing MS prevalence in Latin America and the Caribbean.

A very high prevalence of multiple sclerosis (MS) has been reported in some Western European and North American countries. The few surveys of MS epidemiology in South America reveal lower prevalence rates, implying that susceptibility varies between distinct ethnic groups, thus forming an important determinant of the geographic distribution of the disease. The objective of this study is to review MS prevalence estimates in different Latin American and Caribbean countries. We reviewed surveys of regional MS prevalence from 1991 to 2011. Sources included an online database, authors' reports and proceedings or specific lectures from regional conferences. We obtained a total of 30 prevalence surveys from 15 countries, showing low/medium MS prevalence rates. Both the number and the quality of prevalence surveys have greatly improved in this region over recent decades. This is the first collaborative study to map the regional frequency of MS. Establishment of standardized methods and joint epidemiological studies will advance future MS research in Latin America and the Caribbean.

The Brazilian database on pregnancy in multiple sclerosis.

OBJECTIVES: To report the results from the Brazilian database on multiple sclerosis (MS) and pregnancy. METHODS: Retrospective data from MS patients who became pregnant at any time of their disease were sent to a Brazilian database, using a specific file for this purpose. RESULTS: Data on 128 women (142 pregnancies) from 30 neurologists working in 21 cities in Brazil were collected. Patients' average age at pregnancy was 29.8 years (range 16-42). EDSS at start of pregnancy was 1.5±1.4; and the relapse rate in the year preceding pregnancy was 1.2±1.5. Exposure to medication at any time during pregnancy was high (69.7%): 48.6% to interferon beta; 14.1% to glatiramer acetate; and 7% to other immunomodulatory and immunosuppressive drugs. There was a significant decrease in relapse rate during pregnancy. The prevalence of complications was relatively low, with 4.9% of obstetric and 1.4% neonatal unfavorable outcomes. CONCLUSIONS: Our patients had low degrees of disability, short histories of disease, high drug exposure, and relatively high relapse rate in the year previous to pregnancy. Obstetric and neonatal outcomes were successful in over 90% of our patients.

[Non-familial episodic ataxia possibly associated with the use of nicotine: case report]. / Ataxia episódica não familiar possivelmente associada com o uso de nicotina: relato de caso.

The author reports a case of non-familial episodic ataxia responsive to acetazolamide, clinically similar to episodic ataxia type 2 (EA-2), in which nicotine is a possible factor in the origin of the ataxic episodes.

[Guillain-Barré syndrome associated with acute pancreatitis. Case report]. / Síndrome de Guillain-Barré associada a pancreatite aguda. Relato de caso.

We report a clinical case of Guillain-Barré syndrome associated with acute pancreatitis, and perform a review in literature about clinical complications related to Guillain-Barré syndrome. We suggest the possibility of being the events immunologically related.

[Tropical spastic paraparesis/HTLV-I associated myelopathy. Report of 2 cases diagnosed in Cuiabá, Mato Grosso, Brazil]. / Paraparesia espástica tropical/mielopatia associada ao HTLV-I. Relato de dois casos diagnosticados em Cuiabá, Mato Grosso.

We describe two cases of tropical spastic paraparesis/HTLV-I associated myelopathy, according to the criteria of World Health Organization-1989. These are the first cases diagnosed in Cuiabá (Mato Grosso State, Brazil). One of them had a good response with the treatment with prednisone.

[HTLV-I-associated myelopathy/tropical spastic paraparesis: report of 2 cases diagnosed in Florianópolis, Santa Catarina, Brazil]. / Paraparesia espástica tropical/mielopatia associada ao HTLV-I. Relato de dois casos diagnosticados em Florianópolis, Santa Catarina.

We describe two cases of tropical spastic paraparesis/HTLV-I associated myelopathy, according to the criteria of World Health Organization-1989. These are the first cases diagnosed in Florianópolis (Santa Catarina State-Brazil). One of them had a good response with the treatment with methylprednisolone.

Síndrome POEMS: relato de um caso brasieliro com evoluçäo fatal / POEMS syndrome: report of a brazilian case with fatal evolution

Os autores relatam o caso de um homem de 27 anos com grave polineuropatia, múltiplos distúrbios endócrinos, ascite, edemas, alteraçöes de pele e lesöes osteocondensantes em vários ossos. O diagnóstico clínico e laboratorial é compatível com síndrome POEMS. O paciente evoluiu mal, vindo a falecer. É feita revisäo da literatura. Näo se constatou relato brasileiro prévio dessa enfermidade.

[POEMS syndrome: report of a Brazilian case with fatal course]. / Síndrome POEMS: relato de um caso brasileiro com evolução fatal.

The authors report a case of a 27 year old man with severe polyneuropathy, multiple endocrine and cutaneous disorders, ascites, edema and multiple osteosclerotic lesions. Clinical and laboratory diagnosis of POEMS syndrome was made. The patient condition worsened progressively and death followed. The literature search showed that this is the first Brazilian case report about such a syndrome.