Introducere. Scleroza multiplă (SM) este o boală neurologică complexă, cronică, progresivă, imun mediată, cu semne patologice distinctive proceselor de inflamație, demielinizare, remielinizare şi neurodegenerare. Stabilirea unui diagnostic ferm de SM este dificilă la etapa timpurie a bolii. Scopul lucrării. Studierea manifestărilor clinice de debut şi a particularităților evolutive ale maladiei la pacienții cu SM. Material şi metode. Studiu prospectiv şi retrospectiv, descriptiv al unui lot de 215 pacienți cu SM certă (vârsta: 40 [20-66] de ani). Au fost examinați 30 de pacienți, analizate 185 de fişe medicale. Metode utilizate: examen obiectiv, extragerea informației din fişe, interpretarea RMN, Expanded Disability Status Scale (EDSS). Datele sunt prezentate sub formă de medie de cazuri [extreme] şi valori relative. Rezultate. SM a debutat la vârsta 29 [10-52] de ani cu sindrom piramidal – 53%, tulburări de sensibilitate – 41%, cerebeloase – 39%, afectare de nervi cranieni – 28%, dereglări sfincteriene – 8%, tulburări psiho-cognitive – 3%. O singură manifestare la debutul bolii au relatat 48% dintre pacienți; 35% au menționat asocierea a 2 şi 16% – a 3 manifestări. Ulterior, frecvența simptomelor a crescut. De la debutul semnelor clinice, diagnosticul cert de SM a fost stabilit în 39% de cazuri, în 25% – alt diagnostic (alte 28 de nosologii), 36% – nu s-au consultat la medic. Durata medie de confirmare a SM a fost 3 ani de la debut, maxim 38 de ani. Concluzii. SM este extrem de eterogenă referitor la debutul manifestărilor clinice şi evoluția lor, ceea ce face progresia bolii dificil de prezis.

Introduction. Multiple Sclerosis (MS) is a complex chronic neurological, progressive, immune mediated disease, characterized by the following pathological signs as inflammation, demyelination, remyelination and neurodegeneration. Establishing a firm diagnosis of MS is difficult at the early stage of the disease. Objective of the study. The study of the disease onset and its characteristic development in patients with MS. Material and methods. Prospective and retrospective, descriptive study of a group of 215 patients with definite MS (age: 40 [20-66] years); 30 patients were examined and 185 medical records were analysed. Methods: physical examination, data base extraction, interpretation of MRI, Expanded Disability Status Scale (EDSS). Data are presented as mean and [extremes], and relative values. Results. MS started at age 29 [10-52] years with pyramidal syndrome – 53%, sensitivity disorders – 41%, cerebellar – 39%, cranial nerves – 28%, sphincter disorders – 8%, disorders of psycho-cognitive – 3%. One manifestation of the disease onset was reported in 48% of patients, 35% mentioned association of 2, and 16% – of 3 events. Thereafter, the frequency of symptoms increased. From the onset of clinical signs the MS diagnosis was certainly established in 39% of cases, 25% – other diagnosis (another 28 diseases), 36% – didn’t address to the doctor. The mean period of MS confirmation was 3 years since its onset; maximum 38 years. Conclusions. MS is highly heterogeneous in its onset of clinical manifestations and evolution, therefore, it is difficult to predict the disease progression.