Critical Care and Shock

Clinical improvement of multiple sclerosis after implementation of mild therapeutic hypothermia: A case report

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Therapeutic hypothermia is the latest, revolutionary therapy, mostly used in intensive care units after out-of-hospital, and sometimes in-hospital, cardiac arrest due to its neuroprotective effect. This therapeutic intervention has also been used to improve neurological outcome after cerebrovascular accidents and other neurological catastrophes. Multiple sclerosis is one of the main diseases that cause neurological dysfunction in young adults due to its irreversible autonomic nervous system damage. Its main symptoms are tremors, sensory loss, weakness, ataxia and diplopia, and the progression of these end up disabling the patient permanently, sometimes even with the implementation of immunotherapy. We report a patient with a longstanding history of relapsing-remitting multiple sclerosis, with frequent attacks every 1-3 months, that underwent therapeutic hypothermia for 96 hours after in-hospital cardiac arrest; her neurological recovery was outstanding with no neurological deficits caused by the cardiac arrest, and surprisingly, when she was assessed months after the ischemic insult, it was found that she hadn’t presented a relapse of multiple sclerosis since hypothermia was implemented.