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Arquivos de Neuro-Psiquiatria

Print version ISSN 0004-282X

Arq. Neuro-Psiquiatr. vol.49 no.4 São Paulo Dec. 1991

http://dx.doi.org/10.1590/S0004-282X1991000400013 

CONTENTS CONTEÚDO

 

Crises parciais motoras induzidas por movimentos em pacientes diabéticos

 

Movement-induced seizures and diabetes mellitus

 

 

Glória M. A. S. TedrusI; Maria Cristina AlbertinII; Newton S. OdashimaI; Lineu C. FonsecaIII

IProfessor Assistente - Departamento de Neuropsiquiatria da Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas (PUCCAMP)
IINeurologista do Hospital e Maternidade Celso Pierro, PUCCAMP - Departamento de Neuropsiquiatria da Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas (PUCCAMP)
IIIProfessor Titular - Departamento de Neuropsiquiatria da Faculdade de Ciências Médicas da Pontifícia Universidade Católica de Campinas (PUCCAMP)

 

 


RESUMO

Levando em conta o número restrito de casos em âmbito internacional e a ausência de publicações na literatura nacional, os autores apresentam três casos de crises motoras focais induzidas por movimentos em pacientes diabéticos com mais de 50 anos de idade. As crises eram numerosas, sendo também desencadeadas ao serem assumidas determinadas posturas. Em dois casos havia hiperglicemia não cetótica. Todos os pacientes apresentavam hemiparesia e, em dois, tal déficit desapareceu após o cotnrole das crises. No outro paciente a hemiparesia era decorrente de acidente vascular cerebral isquêmico instalado 6 meses antes. Síndrome parietal transitória foi observada nos três pacientes. O EEG crítico mostrou, em dois pacientes, descargas na região parieto-occipital e, em um, na região temporal média contralateral. As crises foram resistentes aos anticonvulsivantes, só havendo controle com o tratamento dos distúrbios metabólicos. São discutidos aspectos clínico-eletren-cefalográficos e etiopatogênicos. A pesquisa do caráter reflexo das crises e a dosagem da glicemia devem ser feitas em todos os pacientes idosos com crises motoras focais, face às implicações de ordem terapêutica e prognóstica.


SUMMARY

Three elderly patients with partial motor seizures triggered by movement or posture of an extremity are presented. They had a history of diabetes mellitus. Two of them had nonketotic hyperglycemia. Hemiparesis was present in the three patients, which resolved in two. In the other patient, hemiparesis resulted from a previous stroke. All patients had transitory parietal syndrome. During seizures, BEG showed discharges in the parieto-occipital area in two cases and in the mid-temporal area in one. Seizures were resistant to conventional anticonvulsivante therapy, and ceased only after treatment of metabolic disturbances. A search for reflex seizures and hyperglycemia should be carried out routinely in the elderly with repeated spontaneous focal motor seizures. This may be important for treatment and prognosis.


 

 

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Full text available only in PDF format.

 

 

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Dr. Lineu Corrêa Fonseca - Departamento de Neuropsiquiatria, Faculdade de Ciências Médicas, PUCCAMP - Av. John Boyd Dunlop s/nº - 13060 Campimas SP - Brasil.

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