A síndrome ombro-mão nas hemiplegias vasculares

Souza, Sebastião E. Melo; Sanvito, Wilson; Soola, Álvaro

doi:10.1590/S0004-282X1968000300002

Resumos

São expostos os dados obtidos em 18 casos de síndrome ombro-mão, encontrados mediante revisão de 175 pacientes acometidos de afecção cerebro-vascular aguda. Em todos os casos a síndrome se instalou no lado paralisado, evidenciando a importância da imobilização. O início se deu, na maioria das vezes, por edema de mão, aparecendo dentro de duas a três semanas após o icto. Os resultados eletromiográficos obtidos em 7 casos, são comentados. O tratamento de maior êxito se deve à cinesiterapia, podendo-se associar a griseofulvina, útil no alívio da dor.

From 175 cases of cerebrovascular disease, 18 patients with shoulder-hand syndrome are studied. In all patients the syndrome involved the paralysed limb, a fact that points to immobility as a enhancing factor. Hand edema occurring two to three weeks after the stroke was the first sign of the syndrome. Eletromyographic data were evaluated in 7 patients. Griseofulvine (for pain) and kinesiotherapy are the best available tratment.

A síndrome ombro-mão nas hemiplegias vasculares

Shoulder-hand syndrome in cerebrovascular hemiplegia

Sebastião E. Melo Souza^I; Wilson Sanvito^II; Álvaro Soola^III

^IMédico estagiário; Da Clínica Neurológica do Hospital do Servidor Público do Estado de São Paulo (Chefe: Dr. Roberto Melaragno Filho)

^IIAssistente; Da Clínica Neurológica do Hospital do Servidor Público do Estado de São Paulo (Chefe: Dr. Roberto Melaragno Filho)

^IIIMédico auxiliar; Da Clínica Neurológica do Hospital do Servidor Público do Estado de São Paulo (Chefe: Dr. Roberto Melaragno Filho)

RESUMO

São expostos os dados obtidos em 18 casos de síndrome ombro-mão, encontrados mediante revisão de 175 pacientes acometidos de afecção cerebro-vascular aguda. Em todos os casos a síndrome se instalou no lado paralisado, evidenciando a importância da imobilização. O início se deu, na maioria das vezes, por edema de mão, aparecendo dentro de duas a três semanas após o icto. Os resultados eletromiográficos obtidos em 7 casos, são comentados. O tratamento de maior êxito se deve à cinesiterapia, podendo-se associar a griseofulvina, útil no alívio da dor.

SUMMARY

From 175 cases of cerebrovascular disease, 18 patients with shoulder-hand syndrome are studied. In all patients the syndrome involved the paralysed limb, a fact that points to immobility as a enhancing factor. Hand edema occurring two to three weeks after the stroke was the first sign of the syndrome. Eletromyographic data were evaluated in 7 patients. Griseofulvine (for pain) and kinesiotherapy are the best available tratment.

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Clínica Neurológica Hospital do Servidor Público Estadual Rua Pedro de Toledo 1800 São Paulo, SP Brasil.

1. ARLET, J.; RASCOL, A.; MOLE, J. & ROGER, J. M. Observations de rhumatisme gardénalique. Rev. Rhum. 4:193-198, 1967.
2. BAYLES, T. B.; JUDSON, W. E. & POTTER, T. A. Reflex simpathetic dystrophy of the upper extremity (Hand-shoulder syndrome). J.A.M.A. 7:537-542, 1950.
3. EDEIKEN, J. Shoulder-hand syndrome following myocardial infarction with special reference to prognosis. Circulation 1:14-19, 1957.
4. ELLIS, L. B. & WEISS, S. Vasomotor disturbance and edema associated with cerebral hemiplegia. Arch. Neurol. Psychiat. 26:362, 1936.
5. ENNEVARA, K. Painful shoulder joint in rheumatoid arthritis. Acta Rheum. Scand. Suplemento 11, 1967.
6. ESKWTTH, I. S. Treatment of the shoulder-hand syndrome. Postgrad. Med. 1:800-804, 1959.
7. GOOD, A. E.; GREEN, R. A. & ZARAFONETIS, C. J. D. Rheumatic symptoms during tuberculosis therapy. Ann. Int. Med 2:800-807, 1965
8. ISCH, F. Electromyographic. Editions Doin, Paris, 1963.
9. JOHNSON, E. W. & PANNOZZO, A. N. Management of shoulder-hand syndrome. J.A.M.A. 2:108-110, 1966.
10. KORST, J K. Van der; COLENBRANDER, H. & CASTS, A. Phenobarbital and the shoulder-hand syndrome. Ann. Rheum. Dis. 6:553-555, 1966.
11. LEQUESNE, M. & MOGHTADER, R. L'algodystrophie de l'isoniazide et de rethionamide. Rev. Rhum. 12:727-734, 1966.
12. MARCHE, J. & CHATARD, P. Le pseudo-rhumatisme de la chimiothérapie antituberculeuse. Contribution a 1'etude-pathogénique du rhumatisme neuro-trophique. Rev. Rhum. 1-11:16-33, 1967.
13. MOGENSEN, E. F. Painful shoulder: aetiologieal and pathogenetic problems. Acta Med. Scand. Fascículo, 3:195-203, 1956.
14. MOGENSEN, E. F. Painful shoulder: the prognosis in 282 followup cases. Acta Med. Scand. Fascículo, 1:15-24, 1956.
15. RAVAULT, P. P. & BOUVIER, M. Les algodystrophies. Rev. Practicien 18:2529-2545, 1966.
16. ROSEN, P. S. & GRAHAM, W. The shoulder-hand syndrome: historical review with observations on seventy-three patients. Canad. Med. Ass. J. 77: 86-91, 1963.
17. ROSEN, P. S. & GRAHAM, W. Shoulder-hand syndrome in coronary disease. Geriatrics 7:525-532, 1963.
18. RUSSEK, H. I. Shoulder-hand syndrome following myocardial infarction. Med. Clin. North Amer. 1555-1566, 1958.
19. RUSSEK, H. I.; RUSSEK, A. S.; DOERNERN, A. A. & ZOHMAN, B. L. Cortisone treatment of shoulder-hand syndrome following acute myocardial infarction. Arch. Int. Med. 4:487-492, 1953.
20. SALOMON, A. & BLOCH-MICHEL, H. Utilisation de la griséofulvine en rhumatologie et en particulier au cours des algodystrophies reflexes. Presse Med. 33:1987, 1964.
21. STEINBROCKER, O. The shoulder-hand syndrome. Amer. J. Med. 4:402-407, 1947.
22. STEINBROCKER, O. Arthritis and Allied Conditions. Lea & Febiger, Philadelphia, 1966.
23. STEINBROCKER, O. & AGYROS, T. G. The shoulder-hand syndrome: present status as a diagnostic and treatment entity. Med. Clin. North Amer. 1533-1554, 1958.
24. STEINBROCKER, O.; SPITZER, N. & FRIEDMAN, H. H. The shoulder-hand syndrome in reflex dystrophy of the upper extremity. Ann. Int. Med. 1:22-52, 1948.
25. SWAN, D. M. Shoulder-hand syndrome following hemiplegia. Neurology 4:480-482, 1954.
26. TAKATS, G. Sympathetic reflex dystrophy. Med. Clin. North Amer. 1:117-129, 1965.
27. TRIDON, P.; WEBET, N. & TOUSSAIN, P. Efficacité de la griséofulvine au cours de syndrome douloureux neuro-rhumatologiques. Ann. Med. Nancy 1:65-68, 1966.

Datas de Publicação

Publicação nesta coleção
13 Maio 2013
Data do Fascículo
Set 1968

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

[1] 1. ARLET, J.; RASCOL, A.; MOLE, J. & ROGER, J. M. Observations de rhumatisme gardénalique. Rev. Rhum. 4:193-198, 1967.

[2] 2. BAYLES, T. B.; JUDSON, W. E. & POTTER, T. A. Reflex simpathetic dystrophy of the upper extremity (Hand-shoulder syndrome). J.A.M.A. 7:537-542, 1950.

[3] 3. EDEIKEN, J. Shoulder-hand syndrome following myocardial infarction with special reference to prognosis. Circulation 1:14-19, 1957.

[4] 4. ELLIS, L. B. & WEISS, S. Vasomotor disturbance and edema associated with cerebral hemiplegia. Arch. Neurol. Psychiat. 26:362, 1936.

[5] 5. ENNEVARA, K. Painful shoulder joint in rheumatoid arthritis. Acta Rheum. Scand. Suplemento 11, 1967.

[6] 6. ESKWTTH, I. S. Treatment of the shoulder-hand syndrome. Postgrad. Med. 1:800-804, 1959.

[7] 7. GOOD, A. E.; GREEN, R. A. & ZARAFONETIS, C. J. D. Rheumatic symptoms during tuberculosis therapy. Ann. Int. Med 2:800-807, 1965

[8] 8. ISCH, F. Electromyographic. Editions Doin, Paris, 1963.

[9] 9. JOHNSON, E. W. & PANNOZZO, A. N. Management of shoulder-hand syndrome. J.A.M.A. 2:108-110, 1966.

[10] 10. KORST, J K. Van der; COLENBRANDER, H. & CASTS, A. Phenobarbital and the shoulder-hand syndrome. Ann. Rheum. Dis. 6:553-555, 1966.

[11] 11. LEQUESNE, M. & MOGHTADER, R. L'algodystrophie de l'isoniazide et de rethionamide. Rev. Rhum. 12:727-734, 1966.

[12] 12. MARCHE, J. & CHATARD, P. Le pseudo-rhumatisme de la chimiothérapie antituberculeuse. Contribution a 1'etude-pathogénique du rhumatisme neuro-trophique. Rev. Rhum. 1-11:16-33, 1967.

[13] 13. MOGENSEN, E. F. Painful shoulder: aetiologieal and pathogenetic problems. Acta Med. Scand. Fascículo, 3:195-203, 1956.

[14] 14. MOGENSEN, E. F. Painful shoulder: the prognosis in 282 followup cases. Acta Med. Scand. Fascículo, 1:15-24, 1956.

[15] 15. RAVAULT, P. P. & BOUVIER, M. Les algodystrophies. Rev. Practicien 18:2529-2545, 1966.

[16] 16. ROSEN, P. S. & GRAHAM, W. The shoulder-hand syndrome: historical review with observations on seventy-three patients. Canad. Med. Ass. J. 77: 86-91, 1963.

[17] 17. ROSEN, P. S. & GRAHAM, W. Shoulder-hand syndrome in coronary disease. Geriatrics 7:525-532, 1963.

[18] 18. RUSSEK, H. I. Shoulder-hand syndrome following myocardial infarction. Med. Clin. North Amer. 1555-1566, 1958.

[19] 19. RUSSEK, H. I.; RUSSEK, A. S.; DOERNERN, A. A. & ZOHMAN, B. L. Cortisone treatment of shoulder-hand syndrome following acute myocardial infarction. Arch. Int. Med. 4:487-492, 1953.

[20] 20. SALOMON, A. & BLOCH-MICHEL, H. Utilisation de la griséofulvine en rhumatologie et en particulier au cours des algodystrophies reflexes. Presse Med. 33:1987, 1964.

[21] 21. STEINBROCKER, O. The shoulder-hand syndrome. Amer. J. Med. 4:402-407, 1947.

[22] 22. STEINBROCKER, O. Arthritis and Allied Conditions. Lea & Febiger, Philadelphia, 1966.

[23] 23. STEINBROCKER, O. & AGYROS, T. G. The shoulder-hand syndrome: present status as a diagnostic and treatment entity. Med. Clin. North Amer. 1533-1554, 1958.

[24] 24. STEINBROCKER, O.; SPITZER, N. & FRIEDMAN, H. H. The shoulder-hand syndrome in reflex dystrophy of the upper extremity. Ann. Int. Med. 1:22-52, 1948.

[25] 25. SWAN, D. M. Shoulder-hand syndrome following hemiplegia. Neurology 4:480-482, 1954.

[26] 26. TAKATS, G. Sympathetic reflex dystrophy. Med. Clin. North Amer. 1:117-129, 1965.

[27] 27. TRIDON, P.; WEBET, N. & TOUSSAIN, P. Efficacité de la griséofulvine au cours de syndrome douloureux neuro-rhumatologiques. Ann. Med. Nancy 1:65-68, 1966.