Clinical aspects, electromyographic and evolution of neuroschistosomiasis patients

THESES

Clinical aspects, electromyographic and evolution of neuroschistosomiasis patients (Abstract)^*. Dissertation. Recife, 2004

Carolina da Cunha Correia

^{Correspondence}

Mansoni schistosomiasis is a parasitIc disease that assault nearly 10% of total Brazilian population, mainly from northwest, and it constitutes an important public health problem. The neurological presentation is especially severe because of motor, sensitive, sphincterian and erectile disturbances associated with neuroschistosomiasis, that are difficult to recuperate.

Objectifying to describe clinical and electromyography aspects of neuroschistosomotic patients, analyzing clinical evolution, the author studied 47 patients, aging from 14 to 65 years old, 11 (23.4%) females, who attempted emergency or ambulatory consultation at neurological service of Hospital da Restauração, Recife, Pernambuco, Brazil, from 2000 June to 2003 June. One has evaluated clinical manifestations, magnetic resonance image alterations, cellular and biochemical characteristics of cerebrospinal fluid, ultrasound hepatosplenic findings, motor, sensitive and sphincter evolution and electromyography patterns, besides the relation of these findings and the motor clinical evolution after a median period of three months after hospital discharge.

Main clinical manifestations included isolated sphincter disturbances (100%), motor deficit (95.7%) and sensibility alterations (83%). The anatomical level most frequently involved was low thoracic region from T6 to T12 (57.4%). Thirty four (91.9%) of 37 patients submitted to magnetic resonance presented hyposignal at T1 and hypersinal at T2, with contrast capture predominantly at thoracic region, isolated or extended to spinal cord cone. On cerebrospinal fluid, the findings were pleocytosis (93.6%) with lymphmonocytic pattern. Hepatosplenomegaly was absent for 32 of 38 (84.2%) patients submitted to abdominal ultrasound. Electromyographic pattern of 95.2% patients was compatible to axonal lumbosacral multirradiculopathy, with variable denervation extension, but predominant from level L2 to S2.

Within revaluation, motor disturbances more frequently disappeared; the sensitive ones got better and sphincter ones did not alter. There was worst motor recuperation on patient with more extensive denervation at electromyography.

Key words: neuroschistosomiasis, electromyography, diagnosis.

*

Aspectos clínicos, eletromiográficos e de evolução de pacientes com neuroesquistossomose ( Resumo). Dissertação de Mestrado, Universidade de Pernambuco (área: Clínica Médica). Orientador: Luiz Ataíde Júnior; co-orientador: Otávio Gomes Lins.

O arquivo disponível sofreu correções conforme ERRATA publicada no Volume 63 Número 1 da revista.

Publication Dates

• Publication in this collection
  25 Apr 2006
• Date of issue
  Dec 2004