Protocolo diagnóstico y terapéutico del brote de enfermedad desmielinizante

Relapsing-remitting multiple sclerosis is characterized by episodic pattern of outbreaks followed by periods of clinical remission. Outbreak is a clinical entity defined as appearance of new or worsening of previous neurological symptoms lasting more than 24 h. Diagnosis is mainly clinical. Differential diagnosis with concomitant systemic conditions or pseudo-outbreaks is fundamental. The treatment is intravenous or oral methylprednisolone bolus for 3-5 days, followed or not by decreasing doses. Repetition treatment or the use of other therapies (for example plasmapheresis) are indicated when the first treatment is not effective.