A 34-year-old woman, nurse, came to the INSS Medical Disability Assessment Unit for evaluation of TI.
The reason for the current absence is neuropatic pain (no reports).
She was diagnosed with MS 10 years ago and had presented 6 sprouts requiring treatment with Copaxone® (Glati ́s Acceptance).
He had worked in the emergency unit previously, but for three years, due to the EM brothels, he was relocated in the area of urology consultations.
She had been diagnosed with fibromyalgia, chronic fatigue and anxiety-depressive symptoms.
The current treatment is: Cymbalta® (Duloxetine hydrochloride) 60 mg orally (VO) 1-1/2-0,oxl® (1⁄2 150 mg® (reg-1 VOZ-1 mg VO-1).
You are not receiving immunomodulatory treatment.
On physical examination: normal upper limb, collaborator, normal sense weakness or altered gait normal left cranial nerves, normal symmetrical strength and balance, negative limb, lightweight face, normal hemitendinous reflexes with hypercorpus
Estimated EDSS 1.0.
1.
Background
MS is the most common inflammatory disorder of the central nervous system (CNS) that affects myelin both in the brain and spinal cord in one or more places; it is also one of the most important causes of disability in young adults1
It is known that 50% of patients progress to a persistent deficit 15 years after the onset of the disease and 80% at 30 years 2,3.
The epidemiology of MS is changing in recent years and the traditionally admitted is questioned: the gradient of higher prevalence and north-south incidence (in the northern hemisphere) or, when we are concerned, its increase.
In the last decade there is a major consensus on an increase in the prevalence and incidence of this disease in Europe, the Mediterranean basin and possibly worldwide.
The increase in its incidence may be due to a better detection of the disease (grades to the appearance of magnetic resonance imaging), and the prevalence, to a greater survival of patients with MS 4.
The Mcnald criteria for MS diagnosis for 2005 5 are used, which considers the dissemination of demyelinating lesions in time and space.
Because this disease affects young adults who are in work activity it is important to assess the functional impact of the disease on the different capabilities of the person in the workplace.
