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Sin embargo, a\u00fan persisten \u00e1reas de incertidumbre y desaf\u00edos. A nivel mundial, se ha observado un incremento notorio de los casos de esclerosis m\u00faltiple. En Colombia, por ejemplo, los estudios m\u00e1s recientes han reportado un cambio de la prevalencia menor de 5 por cada 100 000 habitantes a 7,5 casos por cada 100 000 habitantes. Es esencial que los neur\u00f3logos est\u00e9n al tanto de los tratamientos actuales para brindar asesoramiento adecuado a estos pacientes.Esta revisi\u00f3n aborda ocho controversias relevantes en esclerosis m\u00faltiple y otras enfermedades desmielinizantes, basada en la evidencia m\u00e1s reciente. Los temas incluyen la suspensi\u00f3n de tratamientos en adultos mayores, el uso de pruebas gen\u00e9ticas para el diagn\u00f3stico, las recomendaciones sobre planificaci\u00f3n familiar, la prevenci\u00f3n de reca\u00eddas posparto y el espectro de neuromielitis \u00f3ptica. Tambi\u00e9n se analizan la indicaci\u00f3n de terapia con c\u00e9lulas madre, el riesgo de neoplasias malignas asociadas a la inmunoterapia, el manejo de la linfopenia y las estrategias para mitigar el efecto de rebote al suspender los tratamientos modificadores de la enfermedad. Cada controversia incluye recomendaciones para orientar la toma de decisiones en la pr\u00e1ctica cl\u00ednica diaria, adapt\u00e1ndose a las realidades de pa\u00edses como Colombia, donde son cruciales los avances en formaci\u00f3n neurol\u00f3gica y acceso a tratamientos.<\/jats:p>","DOI":"10.7705\/biomedica.7882","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T14:30:47Z","timestamp":1772807447000},"page":"141-162","update-policy":"https:\/\/doi.org\/10.7705\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Controversias en neuroinmunolog\u00eda: esclerosis m\u00faltiple y otras enfermedades desmielinizantes","Controversies in neuroimmunology: Multiple sclerosis and other demyelinating disorders"],"prefix":"10.7705","volume":"46","author":[{"given":"Ana C.","family":"Villegas","sequence":"first","affiliation":[{"name":"Programa de Neurolog\u00eda, Universidad El Bosque, Bogot\u00e1, D. 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