Resumos
Os autores registram um caso de mielite transversa pós-infecciosa em paciente que apresenta espinha bifida oculta torácica, no mesmo nível. Estas duas condições clínicas são infreqüentes e o fato de surgirem em um mesmo paciente e, ainda, no mesmo nível, leva ao raciocínio de que estejam relacionadas uma à outra. Os autores pensam que o defeito congênito vertebral estabeleceu um "ponto vulnerável" naquela área predispondo o paciente a que ali se estabelecesse a complicação medular pós-infecciosa ("locus minor resistentia").
The patient, a 30 year-old man, dentist, started having an influenza-like infection which lasted five days, with malaise, muscle pain throughout the body and fever- One day before the hospital admission he presented urinary retention followed in the next day by ataxia and numbness sensation in both feet and lower third of his legs. The neurological examination disclosed a thoracic spinal cord impairment at T9-T10 level and the diagnosis of a post- infectious transverse myelitis was made. The plain Rx of the spine showed a spina bifida oculta in the T7 vertebra, which is roughly at the same level of the T9-T10 spinal cord segment. An iodinated myelography showed no abnormalities. The CSF examination showed small increase in the white cells (6.4 cells/cu.mm). The patient received dexamethasone (4.5g/day) and two weeks later was entirely free of symptoms. The authors think that the congenital bone defect (spina bifida) might have played a role in the development of the myelitis, probably because of an ontogenetically determined "vulnerable point" ("locus minor resistentia") at that level, either anatomical or immunological.
Mielite transversa pós-infecciosa e espinha bifida toracica. Registro de um caso
Post-infectious transverse myelitis and thoracic spina bifida. Report of a case
Luiz Augusto F. AndradeI; Pedro Simões RosadoII
IProfessor Adjunto. Departamento de Neurologia e Neurocirurgia da Escola Paulista de Medicina
IIProfessor Auxiliar de Neurologia na Faculdade de Medicina de Belém, Pará
RESUMO
Os autores registram um caso de mielite transversa pós-infecciosa em paciente que apresenta espinha bifida oculta torácica, no mesmo nível. Estas duas condições clínicas são infreqüentes e o fato de surgirem em um mesmo paciente e, ainda, no mesmo nível, leva ao raciocínio de que estejam relacionadas uma à outra. Os autores pensam que o defeito congênito vertebral estabeleceu um "ponto vulnerável" naquela área predispondo o paciente a que ali se estabelecesse a complicação medular pós-infecciosa ("locus minor resistentia").
SUMMARY
The patient, a 30 year-old man, dentist, started having an influenza-like infection which lasted five days, with malaise, muscle pain throughout the body and fever- One day before the hospital admission he presented urinary retention followed in the next day by ataxia and numbness sensation in both feet and lower third of his legs. The neurological examination disclosed a thoracic spinal cord impairment at T9-T10 level and the diagnosis of a post- infectious transverse myelitis was made. The plain Rx of the spine showed a spina bifida oculta in the T7 vertebra, which is roughly at the same level of the T9-T10 spinal cord segment. An iodinated myelography showed no abnormalities. The CSF examination showed small increase in the white cells (6.4 cells/cu.mm). The patient received dexamethasone (4.5g/day) and two weeks later was entirely free of symptoms. The authors think that the congenital bone defect (spina bifida) might have played a role in the development of the myelitis, probably because of an ontogenetically determined "vulnerable point" ("locus minor resistentia") at that level, either anatomical or immunological.
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Full text available only in PDF format.
Trabalho da Disciplina de Neurologia do Departamento de Neurologia e Neurocirurgia da Escola Paulista de Medicina.
Disciplina de Neurologia do Departamento de Neurologia e Neurocirurgia _ Escola Paulista de Medicina - Rua Botucatu, 740 - 04023, São Paulo, SP - Brasil.
- 1. BENADY, S.; BEN ZVI, A. & SZABO, G. - Transverse myelitis following mumps. Acta paediat. scand. 62:206, 1973.
- 2. INGRAHAM, F.D. & SWAN, H. - Spina bifida and cranium bifidum: survey of 546 cases. N. Engl. J. Med. 228:559, 1943.
- 3. OWEN, N.L. - Myelitis following type A-2 influenza. J. amer. Med. Assoc. 64:1752, 1969.
- 4. OWEN, N.L. - Myelitis following type A-2 influenza. J. aumer Med. Assoc. 215:1986, 1971.
- 5. WESOLEK, I. - Transverse myelitis in the course of measles in a 7 years old boy. Neurol. Neurochir. Pol. 4:471, 1970.
Datas de Publicação
-
Publicação nesta coleção
14 Ago 2012 -
Data do Fascículo
Mar 1984
