Arquivos de Neuro-Psiquiatriahttps://www.scielo.br/feed/anp/2007.v65n3a/2024-03-19T20:31:12.227000ZUnknown authorVol. 65 No. 3a - 2007WerkzeugTemporal pole signal abnormality on MR imaging in temporal lobe epilepsy with hippocampal sclerosis: a fluid-attenuated inversion-recovery study10.1590/S0004-282X20070004000012024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZCarrete Junior, HenriqueAbdala, NitamarLin, KátiaCaboclo, Luís OtávioCenteno, Ricardo SilvaSakamoto, Américo CeikiSzjenfeld, JacobNogueira, Roberto GomesYacubian, Elza Márcia Targas
<em>Carrete Junior, Henrique</em>;
<em>Abdala, Nitamar</em>;
<em>Lin, Kátia</em>;
<em>Caboclo, Luís Otávio</em>;
<em>Centeno, Ricardo Silva</em>;
<em>Sakamoto, Américo Ceiki</em>;
<em>Szjenfeld, Jacob</em>;
<em>Nogueira, Roberto Gomes</em>;
<em>Yacubian, Elza Márcia Targas</em>;
<br/><br/>
OBJECTIVE: To determine the frequency and regional involvement of temporal pole signal abnormality (TPA) in patients with hippocampal sclerosis (HS) using fluid-attenuated inversion-recovery (FLAIR) MR imaging, and to correlate this feature with history. METHOD: Coronal FLAIR images of the temporal pole were assessed in 120 patients with HS and in 30 normal subjects, to evaluate gray-white matter demarcation. RESULTS: Ninety (75%) of 120 patients had associated TPA. The HS side made difference regarding the presence of TPA, with a left side prevalence (p=0.04, chi2 test). The anteromedial zone of temporal pole was affected in 27 (30%) out of 90 patients. In 63 (70%) patients the lateral zone were also affected. Patients with TPA were younger at seizure onset (p=0.018), but without association with duration of epilepsy. CONCLUSION: Our FLAIR study show temporal pole signal abnormality in 3/4 of patients with HS, mainly seen on the anteromedial region, with a larger prevalence when the left hippocampus was involved.Evaluation of white matter in patients with multiple sclerosis through diffusion tensor magnetic resonance imaging10.1590/S0004-282X20070004000022024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZAndrade, Rachel E. Maia deGasparetto, Emerson L.Cruz Jr., Luiz Celso HyginoFerreira, Fabiana BritoDomingues, Roberto CortêsMarchiori, EdsonDomingues, Romeu Cortês
<em>Andrade, Rachel E. Maia De</em>;
<em>Gasparetto, Emerson L.</em>;
<em>Cruz Jr., Luiz Celso Hygino</em>;
<em>Ferreira, Fabiana Brito</em>;
<em>Domingues, Roberto Cortês</em>;
<em>Marchiori, Edson</em>;
<em>Domingues, Romeu Cortês</em>;
<br/><br/>
OBJECTIVE: To study the white matter of patients with multiple sclerosis (MS) with diffusion tensor magnetic resonance (MR) imaging (DTI). METHOD: Forty patients with clinical-laboratorial diagnosis of relapsing-remitting MS and 40 age- and sex-matched controls, who underwent conventional and functional (DTI) MR imaging, were included in the study. The DTI sequences resulted in maps of fractional anisotropy (FA) and regions of interest were placed on the plaques, peri-plaque regions, normal-appearing white matter (NAWM) around the plaques, contralateral normal white matter (CNWM) and normal white matter of the controls (WMC). The FA values were compared and the statistical treatment was performed with the Mann-Whitney U test. RESULTS: The mean FA in plaques was 0.268, in peri-plaque regions 0.365, in NAWM 0.509, in CNWM 0.552 and in WMC 0.573. Statistical significant differences in FA values were observed in plaques, peri-plaque regions and in NAWM around the plaques when compared to the white matter in the control group. There was no significant difference between the FA values of the CNWM of patients with MS and normal white matter of controls. CONCLUSION: Patients with MS show difference in the FA values of the plaques, peri-plaques and NAWM around the plaques when compared to the normal white matter of controls. As a result, DTI may be considered more efficient than conventional MR imaging for the study of patients with MS.Heart rate analysis differentiates dialeptic complex partial temporal lobe seizures from auras and non-epileptic seizures10.1590/S0004-282X20070004000032024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZOliveira, Gisele R. deGondim, Francisco de A.A.Hogan, R. EdwardRola, Francisco H.
<em>Oliveira, Gisele R. De</em>;
<em>Gondim, Francisco De A.a.</em>;
<em>Hogan, R. Edward</em>;
<em>Rola, Francisco H.</em>;
<br/><br/>
The distinction of non-epileptic from epileptic events is difficult even for experienced neurologists. We retrospectively evaluated 59 dialeptic events from 27 patients admitted for video EEG monitoring to check whether heart rate (HR) analysis could help in differentiating dialeptic complex partial temporal lobe seizures (TLS) from dialeptic simple partial TLS, and non-epileptic dialeptic events. Baseline HR was increased in the simple partial TLS in comparison to complex partial TLS and non-epileptic groups (p<0.05). HR increase accompanied each individual dialeptic complex partial TLS (100% of the events, p<0.05) bur HR returned to baseline in the post-ictal phase. Ictal HR was not altered in the non-epileptic or simple partial TLS groups. Our findings suggest that ictal centrally mediated tachycardia is characteristic of dialeptic TLS (both tachycardia and bradycardia have been reported during TLS). This finding may be used as a criterion to distinguish dialeptic complex partial TLS from simple partial and non-epileptic dialeptic events.Benign childhood epilepsy with centro-temporal spikes: correlation between clinical, cognitive and EEG aspects10.1590/S0004-282X20070004000042024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZFonseca, Lineu CorrêaTedrus, Glória Maria A.S.Pacheco, Elisabeth Marinelli de CamargoBerretta, Marcela FernandaCampregher, Amanda AugustaCosta, Débora Macedo
<em>Fonseca, Lineu Corrêa</em>;
<em>Tedrus, Glória Maria A.s.</em>;
<em>Pacheco, Elisabeth Marinelli De Camargo</em>;
<em>Berretta, Marcela Fernanda</em>;
<em>Campregher, Amanda Augusta</em>;
<em>Costa, Débora Macedo</em>;
<br/><br/>
Benign childhood epilepsy with centro-temporal spikes (BECTS) is a form of epilepsy with no demonstrable anatomical lesion showing spontaneous seizure remission. During the active phase of the disease the children may show cognitive deficits. The objective of this study was to assess, in children with BECTS, the relationship between clinical-EEG aspects and performance in the school performance test (SPT), Raven's progressive matrixes test and the Wechsler Intelligence Scale for Children (WISC-III). Forty-two 7 to 11 year old children were included and the following tests carried out: anamnesis, neurological examination, electroencephalogram (EEG), SPT, Raven's test and WISC-III. The children with BECTS had normal IQ values but showed inferior performance in the SPT more frequently than "healthy" children, paired with respect to age and maternal scholastic level. There was moderate positive correlation between WISC-III results and the age when the seizures started and the educational level of the parents. On the other hand, aspects linked to the epileptic nature of BECTS, such as the number of seizures, time since last seizure and the number and lateralization of the centro-temporal spikes on the EEG, showed no correlation with the neuropsychological tests.Correlation between the neonatal EEG and the neurological examination in the first year of life in infants with bacterial meningitis10.1590/S0004-282X20070004000052024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZPoblano, AdriánGutiérrez, Roberto
<em>Poblano, Adrián</em>;
<em>Gutiérrez, Roberto</em>;
<br/><br/>
OBJECTIVE: To assess the contribution of neonatal electroencephalogram (EEG) and its correlation with the neurological examination at age of 9 months in newborns with bacterial neonatal meningitis. METHOD: Twenty seven infants were studied with positive cerebrospinal fluid (CSF) culture for bacteria. We used the worse EEG result during acute phase of meningitis, and performed neurologic follow-up after discharge from hospital. Background cerebral activity was classified as normal or mildly, moderately, or markedly abnormal. Neurologic examination outcomes was classified normal, mild abnormalities, moderate abnormalities and severe abnormalities. RESULTS: EEG performed in the neonatal period during acute bacterial meningitis predicts adverse outcome early at age of 9 months, and had a significant correlation with cephalic perimeter and active tone alterations. CONCLUSION: Neonatal EEG is useful for predicting abnormal outcomes, especially cephalic perimeter and active tone abnormalities at 9 months of age in infants with bacterial neonatal meningitis.Prevalence of seizures and associated factors in children under five living in a deprived municipality of southern Brazil10.1590/S0004-282X20070004000062024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZAbib, Cheple RobertoMendoza-Sassi, Raúl A.Bech-Nappi, JaimeStein, Airton Tetelbom
<em>Abib, Cheple Roberto</em>;
<em>Mendoza-Sassi, Raúl A.</em>;
<em>Bech-Nappi, Jaime</em>;
<em>Stein, Airton Tetelbom</em>;
<br/><br/>
OBJECTIVE: To determine the frequency and distribution of seizure in children under five, living in a deprived community. METHOD: This was a cross-sectional study, conducted in a probabilistic sample of 487 children aged 5 or less, resident in the rural and urban areas of São José do Norte, a poor municipality in southern Brazil, during the period 1998-99. Children were identified as having this disorder after the application of the three subsequent instruments, the screening questionnaire for epileptic seizures (SQES), the neurological diagnostic interview for epilepsy (NDIE) and the EEG. Statistical analysis included a multivariate analysis using Poisson regression. Prevalence ratios (PR) and 95% confidence intervals (CI) were calculated. RESULTS: Diagnosis of epileptic seizures was confirmed in 22 children. Prevalence of seizure was 45.2/1000 (CI 2.9-6.8). Absence of tap water (PR 2.86; IC 1.15-7.10), and precarious housing (PR 2.50; CI 1.01-6.18) were significantly associated with the outcome. CONCLUSION: Prevalence of seizure in this deprived population is extremely high and related to socio-economic conditions.Knowledge of stroke among a brazilian urban population10.1590/S0004-282X20070004000072024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZCampos-Sousa, Raimundo NonatoSoares, Vítor Yamashiro RochaAlmeida, Kelson James SilvaCarvalho, Lorena Ibiapina Mendes deJacobina, Kelson SousaAthayde Netto, Arnaldo EscórcioMacêdo, Eduardo de AlmeidaVeloso, Lorenna Andrade
<em>Campos-Sousa, Raimundo Nonato</em>;
<em>Soares, Vítor Yamashiro Rocha</em>;
<em>Almeida, Kelson James Silva</em>;
<em>Carvalho, Lorena Ibiapina Mendes De</em>;
<em>Jacobina, Kelson Sousa</em>;
<em>Athayde Netto, Arnaldo Escórcio</em>;
<em>Macêdo, Eduardo De Almeida</em>;
<em>Veloso, Lorenna Andrade</em>;
<br/><br/>
Knowledge of the population in regards to stroke has clinical and epidemiological importance. Prompt identification of the symptoms means efficient medical attendance within the window of therapeutic opportunities reducing significantly the morbi-mortality. Our aim was to evaluate the level of knowledge of the population of Teresina (PI) concerning factors of risk, symptoms and treatment of stroke. The door-to-door study was carried out by means of a standardized application of questionnaire on risk factors, symptoms and attitude when faced with a stroke victim. 991 forms were selected. Factors of risk more cited were hypertension identified by 416 [42.0%] and hyperlipidemia 284 [28.7%]. The most remembered symptoms were headache 277 [28.0%] and hemiplegia 219 [22.1%]. 375 (37.8%) respondents were unable to identify any risk factors and and 410 (41.4%) any symptom. The lack of knowledge of the population of Teresina in relation to stroke reflects the need for intervention through public and professional educational campaigns.Does botulinum toxin improve the function of the patient with spasticity after stroke?10.1590/S0004-282X20070004000082024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZCardoso, EduardoPedreira, GlíciaPrazeres, AntônioRibeiro, NildoMelo, Ailton
<em>Cardoso, Eduardo</em>;
<em>Pedreira, Glícia</em>;
<em>Prazeres, Antônio</em>;
<em>Ribeiro, Nildo</em>;
<em>Melo, Ailton</em>;
<br/><br/>
Post-stroke spasticity is an important cause of disability in adults, due to muscle hyperactivity, which results in limb stiffness and muscle spasm. The prognosis for these patients depends on several features such as early management and adequate physical therapy to avoid muscle shortening, pain, and their consequences. Although several papers have shown that intramuscular injections of botulinum toxin type A (BT-A) decreases spasticity in post-stroke patients, few authors have demonstrated functional improvement after this therapy. In order to assess if individualized BT-A injections improves upper limb function in post-stroke spastic patients, we prospectively followed 20 consecutive patients of 18 years of age or more with spastic hemiparesis secondary to stroke. Fulg-Meyer scale modified for upper limbs, measure of functional independence (MFI), Ashworth modified scale, and goniometry were applied in the beginning of the investigation and in the 16th and 32nd weeks. BT-A was applied at baseline and in the 16th week. All subjects were submitted to rehabilitation therapy. All patients showed improvement according to Ashworth modified scale and increase in the range of motion, which were sustained until the 32nd week (p<0.05). The assessment of the first three parameters of the Fulg-Meyer scale and the evaluations of the motor part of the Functional Independence Measure showed statistically improvement until the end of the study. We conclude that proper choice of muscles and individualized doses of BT-A can improve function in selected post-stroke patients.Botulinum toxin type A in refractory chronic migraine: an open-label trial10.1590/S0004-282X20070004000092024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZMenezes, CarlaRodrigues, BernardoMagalhães, ElzaMelo, Ailton
<em>Menezes, Carla</em>;
<em>Rodrigues, Bernardo</em>;
<em>Magalhães, Elza</em>;
<em>Melo, Ailton</em>;
<br/><br/>
Botulinum toxin type A (BT-A) has been described as an important strategy to various types of pain such as cervical dystonia, myofascial pain syndrome and headache. Although BT-A efficacy has not been proven in tension type headache, its use in migraine continues controversial. In this open trial, we evaluated the efficacy of BT-A in refractory migraine. BT-A was injected in patients diagnosed with migraine who had previously used three classes of prophylactic drugs by at least one year with no response. The most important improvement was observed within 30 days, but pain intensity and frequency of headache had been decreased until the end of three months of follow up. Side effects of BT-A were mild and self limited. We conclude that BT-A seems to be a safe and effective treatment to refractory migraine patients.Massaging over the greater occipital nerve reduces the intensity of migraine attacks: evidence for inhibitory trigemino-cervical convergence mechanisms10.1590/S0004-282X20070004000102024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZPiovesan, Elcio JuliatoDi Stani, FabrizioKowacs, Pedro AndréMulinari, Rogério AndradeRadunz, Victor HugoUtiumi, MarcoMuranka, Eder BGiublin, Mario LuizWerneck, Lineu César
<em>Piovesan, Elcio Juliato</em>;
<em>Di Stani, Fabrizio</em>;
<em>Kowacs, Pedro André</em>;
<em>Mulinari, Rogério Andrade</em>;
<em>Radunz, Victor Hugo</em>;
<em>Utiumi, Marco</em>;
<em>Muranka, Eder B</em>;
<em>Giublin, Mario Luiz</em>;
<em>Werneck, Lineu César</em>;
<br/><br/>
Activation of the trigemino-cervical system constitutes one of the first steps in the genesis of migraine. The objective of this study was to confirm the presence of trigemino-cervical convergence mechanisms and to establish whether such mechanisms may also be of inhibitory origin. We describe a case of a 39-years-old woman suffering from episodic migraine who showed a significant improvement in her frontal headache during migraine attacks if the greater occipital nerve territory was massaged after the appearance of static mechanical allodynia (cortical sensitization). We review trigemino-cervical convergence and diffuse nociceptive inhibitory control (DNIC) mechanisms and suggest that the convergence mechanisms are not only excitatory but also inhibitory.Acoustic neuroma (vestibular schwannoma): surgical results on 240 patients operated on dorsal decubitus position10.1590/S0004-282X20070004000112024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZCardoso, Arquimedes CavalcanteFernandes, Yvens B.Ramina, RicardoBorges, Guilherme
<em>Cardoso, Arquimedes Cavalcante</em>;
<em>Fernandes, Yvens B.</em>;
<em>Ramina, Ricardo</em>;
<em>Borges, Guilherme</em>;
<br/><br/>
OBJECTIVE: To evaluate the result of the surgical treatment of vestibular schwannoma (VS) operated in dorsal decubitus (mastoid position). METHOD: 240 patients with a VS underwent a retrosigmoid craniotomy for tumor resection in dorsal decubitus (mastoid position). The function of 7th and 8th cranial nerves was monitored during surgery and the opened internal auditory canal (IAC) was reconstructed using a vascularized dura flap, muscle and fibrin glue. RESULTS: Complete tumor removal was achieved in 99% of the cases, with a mortality of 1.6%. The facial nerve function was preserved in 85% of cases and hearing in 40% of the patients (with preoperative hearing) with tumors of up 1.5 cm in diameter. The incidence of cerebrospinal fluid leak was 5.8% and meningitis 2.9%. Venous air embolism was registered in 3% of cases; it was not associated to mortality. CONCLUSION: Surgical removal of VS in dorsal position has several advantages; the morbidity and mortality are very low.Intracranial meningiomas: magnetic resonance imaging findings in 78 cases10.1590/S0004-282X20070004000122024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZGasparetto, Emerson L.Leite, Claudia da CostaLucato, Leandro T.Barros, Cristiano Ventorin deMarie, Sueli K.N.Santana, PedroAguiar, Paulo Henrique Pires deRosemberg, Sérgio
<em>Gasparetto, Emerson L.</em>;
<em>Leite, Claudia Da Costa</em>;
<em>Lucato, Leandro T.</em>;
<em>Barros, Cristiano Ventorin De</em>;
<em>Marie, Sueli K.n.</em>;
<em>Santana, Pedro</em>;
<em>Aguiar, Paulo Henrique Pires De</em>;
<em>Rosemberg, Sérgio</em>;
<br/><br/>
OBJECTIVE: To present the magnetic resonance (MR) imaging findings of 78 patients with meningiomas diagnosed in a single institution. METHOD: 78 patients with histological proven intracranial meningioma were studied. There were 52 female and 26 male patients (median=56 years). All MR imaging examinations were performed with 1.5-T MR imaging unit with standard protocol. The images were studied by two neuroradiologists, who reached the decisions regarding the findings by consensus. RESULTS: Most of the tumors showed low signal on T1- (60%) and high signl on T2- (68%) and FLAIR (69%) weighted images. Also, the lesions showed heterogeneous signal on T1 (60%), T2 (68%) and FLAIR (64%) sequences. After contrast administration, 83% (n=65) of the tumors presented acentuated and 17% (n=13) showed moderate enhancement. The tumors were located in the frontal lobe in 44% of the cases, in the parietal lobe in 35%, the occipital lobe in 19% and the temporal lobe in 12% of the patients. Areas of vasogenic edema around the tumors were seen in 90% of the cases. Twenty six per cent of the cases showed bone infiltration, and the dural tail sign was seen in 59% of the tumors. CONCLUSION: Intracranial meningiomas usually show heterogeneous low signal on T1- and high signal on T2-weighted and FLAIR images, with intense enhancement after contrast administration. The frontal and parietal lobes are commonly affected. In addition, brain edema, dural tail sign and bone infiltration are the most frequent associated findings.Validation of the brazilian version of Guy's neurological disability scale10.1590/S0004-282X20070004000132024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZAraujo, Carolina R.Simão, Luciano M.Ybarra, Mariana I.Faria, Natasha V.M.G.Botelho, Caroline M.Moreira, Marcos A.Teixeira, Antônio L.Lana-Peixoto, Marco A.
<em>Araujo, Carolina R.</em>;
<em>Simão, Luciano M.</em>;
<em>Ybarra, Mariana I.</em>;
<em>Faria, Natasha V.m.g.</em>;
<em>Botelho, Caroline M.</em>;
<em>Moreira, Marcos A.</em>;
<em>Teixeira, Antônio L.</em>;
<em>Lana-Peixoto, Marco A.</em>;
<br/><br/>
The Guy's neurological disability scale (GNDS) has recently been introduced as a new measure of disability in multiple sclerosis. It is patient-oriented, multidimensional, and not biased towards any particular disability. The purpose of the present study was to validate the Brazilian version of the GNDS. The adaptation of the scale was based on the translation/back-translation methodology. Sixty-two patients with clinically definite multiple sclerosis (CDMS) according to Poser's criteria were recruited for this study. GNDS was administered individually to each subject. The EDSS and the ambulation index (AI) scores were assigned by a neurologist. The intraclass correlation coefficient and the Cronbach's alpha values of the Brazilian version of GNDS (0.94 and 0.83, respectively) were comparable to the original one (0.98 and 0.79, respectively). Furthermore, the factor analysis of the Brazilian version of GNDS suggested, as the original article, a four-factor solution which accounted for 68.8% of the total variance. The Brazilian version of GNDS was found to be clinically relevant as it correlated significantly with the EDSS and AI. In conclusion, the Brazilian version of GNDS can be considered an important tool to evaluate the disability in MS patients, with clinical usefulness and psychometrics soundness.Lexical semantic memory in amnestic mild cognitive impairment and mild Alzheimer's disease10.1590/S0004-282X20070004000142024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZBalthazar, Marcio L.F.Martinelli, José E.Cendes, FernandoDamasceno, Benito P.
<em>Balthazar, Marcio L.f.</em>;
<em>Martinelli, José E.</em>;
<em>Cendes, Fernando</em>;
<em>Damasceno, Benito P.</em>;
<br/><br/>
OBJECTIVE: To study lexical semantic memory in patients with amnestic mild cognitive impairment (aMCI), mild Alzheimer's disease (AD) and normal controls. METHOD: Fifteen mild AD, 15 aMCI, and 15 normal control subjects were included. Diagnosis of AD was based on DSM-IV and NINCDS-ADRDA criteria, and that of aMCI, on the criteria of the International Working Group on Mild Cognitive Impairment, using CDR 0.5 for aMCI and CDR 1 for mild AD. All subjects underwent semantic memory tests (Boston Naming-BNT, CAMCOG Similarities item), Rey Auditory Verbal Learning Test (RAVLT), Mini-Mental Status Examination (MMSE), neuropsychological tests (counterproofs), and Cornell Scale for Depression in Dementia. Data analysis used Mann-Whitney test for intergroup comparisons and Pearson's coefficient for correlations between memory tests and counterproofs (statistical significance level was p<0.05). RESULTS: aMCI patients were similar to controls on BNT and Similarities, but worse on MMSE and RAVLT. Mild AD patients scored significantly worse than aMCI and controls on all tests. CONCLUSION: aMCI impairs episodic memory but tends to spare lexical semantic system, which can be affected in the early phase of AD.Cortical asymmetry: catching an object in free fall10.1590/S0004-282X20070004000152024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZVelasques, BrunaMachado, SergioPortella, Cláudio ElidioSilva, Julio GuilhermeTerra, PatríciaFerreira, CamilaBasile, LuisCagy, MauricioPiedade, RobertoRibeiro, Pedro
<em>Velasques, Bruna</em>;
<em>Machado, Sergio</em>;
<em>Portella, Cláudio Elidio</em>;
<em>Silva, Julio Guilherme</em>;
<em>Terra, Patrícia</em>;
<em>Ferreira, Camila</em>;
<em>Basile, Luis</em>;
<em>Cagy, Mauricio</em>;
<em>Piedade, Roberto</em>;
<em>Ribeiro, Pedro</em>;
<br/><br/>
The main goal of the present study was to analyze theta asymmetry through quantitative electroencephalography (qEEG) when individuals were exposed to a sequential motor task, i.e. catching a ball. The sample was composed of 23 healthy subjects, male and female, between 25 and 40 years of age. A two-way factor Anova was applied to compare pre and post moments related to the balls' drop and scalp regions (i.e., frontal and parieto-occipital cortices). The first analysis of the frontal region compared electrodes in the left, right and left/right hemispheres combined, with the frontal midline electrode (FZ) included in the analysis. The results showed moment and region main effects. The second analysis compared left versus right hemisphere without the FZ site. The findings demonstrated an interaction effect between moment and region. The first parieto-occipital analysis, comparing left, right and central regions, with PZ included in all regions, showed main effects of moment and region. The second analysis, comparing left, right (without Pz) and central regions strictly demonstrated a region main effect. Thus, we observed an asymmetric pattern in the frontal cortex (i.e., planning and response selection) when the subjects were waiting for the balls' drop. Moreover, the left hemisphere seems to engage differently from the other regions when the central nervous system needs to prepare for a motor action. On the other hand, the parieto-occipital cortex, which is related to attentive processes, demonstrated a more asymmetric activity towards the right region which implies a participation of this area in cognitive strategies in this particular task. Taken together, we concluded that the adopted experimental approach can be useful to explore several others directions combining sensorimotor integration tasks with different pathologies, such as depression, Alzheimer's and Parkinson's diseases.Changes in cortical relative power in patients submitted to a tendon transfer: a pre and post surgery study10.1590/S0004-282X20070004000162024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZSilva, Julio GuilhermeKnackfuss, Irocy GuedesPortella, Cláudio ElidioMachado, SergioVelasques, BrunaBastos, Victor Hugo do ValeQueiroz, Ricardo de AndradeNeves, Marco Antonio OrsiniPacheco, MarianaVorkapic, Camila FerreiraCagy, MauricioPiedade, RobertoRibeiro, Pedro
<em>Silva, Julio Guilherme</em>;
<em>Knackfuss, Irocy Guedes</em>;
<em>Portella, Cláudio Elidio</em>;
<em>Machado, Sergio</em>;
<em>Velasques, Bruna</em>;
<em>Bastos, Victor Hugo Do Vale</em>;
<em>Queiroz, Ricardo De Andrade</em>;
<em>Neves, Marco Antonio Orsini</em>;
<em>Pacheco, Mariana</em>;
<em>Vorkapic, Camila Ferreira</em>;
<em>Cagy, Mauricio</em>;
<em>Piedade, Roberto</em>;
<em>Ribeiro, Pedro</em>;
<br/><br/>
The aim of this study is analyze possible modifications in the cerebral cortex, through quantitative electroencephalography (qEEG) in patients submitted to a tendon transfer procedure (posterior tibialis) by the Srinivasan's technique. Four subjects (2 men and 2 women), 49.25 age average (SD±21.4) were studied. All subjects have been through surgical procedure due to leprosy and had, at least, two years of drop foot condition. The qEEG measured the electrocortical activity (relative power) between 8 and 25 Hz frequencies pre and post surgery. A paired t test analyzed all data (p<0,05). The results show significant alterations in the alpha relative power, electrodes F7 (p=0.01) and F8 (p=0.021). Altogether, based on findings of the current literature, we can conclude that the tendon transfer procedure suggests electrocortical alterations sensitive to specific qEEG bands.Changes in quantitative EEG absolute power during the task of catching an object in free fall10.1590/S0004-282X20070004000172024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZMachado, SergioPortella, Cláudio ElidioSilva, Julio GuilhermeVelasques, BrunaTerra, PatríciaVorkapic, Camila FerreiraSilva, Vernon Furtado daMiana, LuisBasile, LuisCagy, MauricioPiedade, RobertoRibeiro, Pedro
<em>Machado, Sergio</em>;
<em>Portella, Cláudio Elidio</em>;
<em>Silva, Julio Guilherme</em>;
<em>Velasques, Bruna</em>;
<em>Terra, Patrícia</em>;
<em>Vorkapic, Camila Ferreira</em>;
<em>Silva, Vernon Furtado Da</em>;
<em>Miana, Luis</em>;
<em>Basile, Luis</em>;
<em>Cagy, Mauricio</em>;
<em>Piedade, Roberto</em>;
<em>Ribeiro, Pedro</em>;
<br/><br/>
The aim of this study was to verify changes in absolute power (qEEG), in theta, during the catch of a free falling object. The sample consisted of 10 healthy individuals, of both genders, with ages between 25 and 40 years. A three-way ANOVA followed by Post-Hoc analysis was applied. The results demonstrated main effects for time and position. In conclusion, a motor task that involves expectation produces deactivation of non-relevant areas in the ipsilateral hemisphere of the active limb. On the other hand, the patterns of results showed activation in areas responsible for planning and selection of motor repertories in the contralateral hemisphere.Beta and alpha electroencephalographic activity changes after acute exercise10.1590/S0004-282X20070004000182024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZMoraes, HelenaFerreira, CamilaDeslandes, AndréaCagy, MauricioPompeu, FernandoRibeiro, PedroPiedade, Roberto
<em>Moraes, Helena</em>;
<em>Ferreira, Camila</em>;
<em>Deslandes, Andréa</em>;
<em>Cagy, Mauricio</em>;
<em>Pompeu, Fernando</em>;
<em>Ribeiro, Pedro</em>;
<em>Piedade, Roberto</em>;
<br/><br/>
Exercise has been widely related to changes in cortical activation and enhanced brain functioning. Quantitative electroencephalography (qEEG) is frequently used to investigate normal and pathological conditions in the brain cortex. Therefore, the aim of the present study was to observe absolute power alterations in beta and alpha frequency bands after a maximal effort exercise. Ten healthy young volunteers were submitted to an eight-minute resting EEG (eyes closed) followed by a maximal exercise test using a mechanical cycle ergometer. Immediately after the exercise, another identical eight-minute EEG was recorded. Log transformation and paired student's t-test compared the pre and post exercise values (p<0.05). Results indicated a significant absolute power increase in beta after exercise at frontal (Fp1, F3 and F4) and central (C4) areas, which might be related to increased cortical activation.Os efeitos da estimulação elétrica funcional na assimetria cortical inter-hemisférica10.1590/S0004-282X20070004000192024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZEcard, LetíciaSilva, Andressa Pitanga S. daPeçanha Neto, MarijoseVeiga, HeloisaCagy, MaurícioPiedade, RobertoRibeiro, Pedro
<em>Ecard, Letícia</em>;
<em>Silva, Andressa Pitanga S. Da</em>;
<em>Peçanha Neto, Marijose</em>;
<em>Veiga, Heloisa</em>;
<em>Cagy, Maurício</em>;
<em>Piedade, Roberto</em>;
<em>Ribeiro, Pedro</em>;
<br/><br/>
O objetivo do presente estudo foi avaliar os efeitos da estimulação elétrica funcional na assimetria cortical inter-hemisférica. Para tal, simultaneamente ao registro da atividade eletroencefalográfica, realizou-se eletroestimulação no antebraço direito para estimulação da extensão do indicador. A amostra consistiu de 45 sujeitos randomizados em 3 grupos de 15 sujeitos cada: grupo controle (submetido a 24 blocos de estimulação com intensidade de corrente zero), grupo 1 (24 blocos) e grupo 2 (36 blocos). A assimetria entre os pares de eletrodos F3-F4, C3-C4 e P3-P4 foi analisada ao longo dos grupos através de uma Anova. Os resultados apontaram para uma interação grupo x eletrodo e uma tendência de diminuição da assimetria inter-hemisférica após a eletroestimulação.Alterações do olfato na doença de Parkinson10.1590/S0004-282X20070004000202024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZQuagliato, Lucas BarasneviciusViana, Maura AparecidaQuagliato, Elizabeth Maria Aparecida BarasneviciusSimis, Samuel
<em>Quagliato, Lucas Barasnevicius</em>;
<em>Viana, Maura Aparecida</em>;
<em>Quagliato, Elizabeth Maria Aparecida Barasnevicius</em>;
<em>Simis, Samuel</em>;
<br/><br/>
OBJETIVO: Caracterizar o comprometimento olfatório em 50 pacientes com doença de Parkinson (DP) utilizando o teste de identificação de 12 cheiros da Universidade de Pensilvânia (TICUP), comparando-os com 76 indivíduos normais e associá-lo ao quadro clínico e epidemiológico. MÉTODO: Os pacientes foram avaliados na fase "on" com as escalas unificada da doença de Parkinson (UPDRS), Hoehn e Yahr e TICUP e o grupo controle com o TICUP. RESULTADOS: A média geral do número de acertos foi 5,7 nos parkinsonianos e 9 nos controles, com pontuação menor nos que apresentaram como sintoma inicial tremor e naqueles que atualmente apresentavam tremor, rigidez e bradicinesia. A idade e o estágio da DP correlacionaram-se negativamente com o número de acertos, não havendo correlação da perda olfatória com idade de início do quadro e pontuação da UPDRS. CONCLUSÃO: Apresentaram comprometimento olfatório 80% dos pacientes com DP, sendo essa avaliação ferramenta importante no diagnóstico diferencial.Como a coréia de Sydenham é tratada no Rio de Janeiro?10.1590/S0004-282X20070004000212024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZSouza, Vinicius CastroAraújo, Alexandra PruferAndré, Charles
<em>Souza, Vinicius Castro</em>;
<em>Araújo, Alexandra Prufer</em>;
<em>André, Charles</em>;
<br/><br/>
INTRODUÇÃO: A coréia de Sydenham é a principal causa de coréia adquirida na infância no Brasil. Assim, torna-se relevante saber como os médicos tratam os pacientes coréicos no nosso meio. OBJETIVO: Descrever a prática médica informada em coréia de Sydenham entre pediatras. MÉTODO: Estudo observacional descritivo seccional realizado por entrevistas feitas entre pediatras de emergência e especialistas dos hospitais públicos do Município do Rio de Janeiro. RESULTADOS: 74% dos entrevistados referiu não usar escalas de gravidade; somente 81% dos médicos fazem uso regular de penicilina benzatina; 64% referem iniciar tratamento farmacológico; 28,3% usam apenas o haloperidol para o tratamento. CONCLUSÃO: As escalas de gravidade não são usadas rotineiramente no atendimento de pacientes coréicos; há tendência à prescrição irregular de penicilina entre médicos mais jovens; o haloperidol é a droga mais prescrita entre os entrevistados.Possíveis etiologias da Síndrome de West: avaliação de 95 pacientes10.1590/S0004-282X20070004000222024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZMatta, André Palma da CunhaChiacchio, Soraya Vilani BonacorsiLeyser, Marcio
<em>Matta, André Palma Da Cunha</em>;
<em>Chiacchio, Soraya Vilani Bonacorsi</em>;
<em>Leyser, Marcio</em>;
<br/><br/>
OBJETIVO: Descrever as etiologias da síndrome de West (SW) em um grupo de crianças atendidas no ambiente de um centro de reabilitação. MÉTODO: Análise retrospectiva, avaliando-se os seguintes itens: gênero, idade por ocasião da definição do diagnóstico da SW e sua etiologia. Esta foi dividida em três categorias: sintomática, criptogênica e idiopática. Os casos sintomáticos foram divididos em pré, peri e pós-natais. RESULTADOS: Noventa e cinco pacientes foram incluídos, sendo 59 do gênero masculino (62%). A idade do diagnóstico variou entre 1 e 24 meses, com média de 4,9 (±5,0) meses. Vinte e cinco casos foram considerados criptogênicos (26,3%) e apenas um idiopático (1,1%). Os demais foram classificados com sintomáticos (72,6%), sendo predominantemente casos perinatais. CONCLUSÃO: Nossos achados se assemelham aos da literatura. Conforme se ampliam o conhecimento acerca da SW e os métodos complementares de diagnóstico, haverá tendência à diminuição dos casos hoje considerados criptogênicos ou idiopáticos.Relação entre fadiga e distúrbios autonômicos na esclerose múltipla10.1590/S0004-282X20070004000232024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZLebre, Andréa TemponiMendes, Maria FernandaTilbery, Charles P.Almeida, Ana LuciaScatolini Neto, Argemiro
<em>Lebre, Andréa Temponi</em>;
<em>Mendes, Maria Fernanda</em>;
<em>Tilbery, Charles P.</em>;
<em>Almeida, Ana Lucia</em>;
<em>Scatolini Neto, Argemiro</em>;
<br/><br/>
A fadiga é sintoma comum na esclerose múltipla (EM). O objetivo deste estudo é relacionar a fadiga nos portadores de EM aos distúrbios autonômicos. Participaram deste estudo, 50 pacientes portadores de EM na forma clínica remitente recorrente. Trinta e três (66%) eram mulheres e 17 (34%) homens; pontuação menor ou igual a 3,5 na Escala de EDSS. Foram aplicados em todos os pacientes cinco testes cardiovasculares, já padronizados, para avaliação das funções simpáticas e parassimpáticas. Os resultados encontrados no teste do exercício isométrico foram elevações da pressão arterial de 14,62±9,13 mmHg para o grupo com fadiga e de 21,68±7,18 mmHg para o grupo sem fadiga, sendo estatisticamente significante (p<0,05) a diferença entre os grupos. Conclui-se que há prejuízo na capacidade de elevar a pressão arterial diante de um exercício físico nos portadores de fadiga desta casuística, sugerindo uma disfunção simpática.Esclerose múltipla: adaptação transcultural e validação da escala modificada de impacto de fadiga10.1590/S0004-282X20070004000242024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZPavan, KarinaSchmidt, KiziMarangoni, BrunaMendes, Maria FernandaTilbery, Charles PeterLianza, Sergio
<em>Pavan, Karina</em>;
<em>Schmidt, Kizi</em>;
<em>Marangoni, Bruna</em>;
<em>Mendes, Maria Fernanda</em>;
<em>Tilbery, Charles Peter</em>;
<em>Lianza, Sergio</em>;
<br/><br/>
OBJETIVO: Adaptação transcultural e validação da escala modificada de impacto de fadiga (MFIS-BR). MÉTODO: A MFIS foi traduzida para língua portuguesa e retrovertida para o inglês. Dois estudos piloto foram realizados até ser obtida a MFIS-BR, que foi aplicada em 57 pacientes com esclerose múltipla e 45 controles. O reteste foi 30 dias depois. RESULTADOS: Na análise estatística a reprodutibilidade da consistência interna foi semelhante à escala original (0,74-0,86). A MFIS-BR mostrou-se capaz de identificar os diferentes grupos. Com respeito à reprodutibilidade o coeficiente de correlação interclasses mostrou excelente concordância (0,264-1,0). CONCLUSÃO: A MFIS-BR preenche os critérios de aplicabilidade e sensibilidade de forma semelhante à escala original.Aspectos clínicos e evolutivos da hidrocefalia na neurocisticercose10.1590/S0004-282X20070004000252024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZAgapejev, SvetlanaPouza, Ana Flávia P.Bazan, RodrigoFaleiros, Antonio Tadeu S.
<em>Agapejev, Svetlana</em>;
<em>Pouza, Ana Flávia P.</em>;
<em>Bazan, Rodrigo</em>;
<em>Faleiros, Antonio Tadeu S.</em>;
<br/><br/>
Com o propósito de analisar os aspectos clínicos da hidrocefalia (HDC) na neurocisticercose (NCC), realizou-se o estudo retrospectivo de 47 prontuários de pacientes com HDC e NCC. Verificou-se que 70,2% eram homens, entre 21 e 50 anos. A hipertensão intracraniana (HIC) ocorreu em todos os pacientes, cefaléia (CEF) em 89,4%, meningoencefalite (ME) em 80,8% e distúrbios psíquicos (PSI) em 74,5%. A síndrome liquórica da NCC foi detectada em 65,9% pacientes. Além da HDC, as tomografias computadorizadas de crânio (TC) mostraram lesões císticas e edema cerebral difuso em 59,6% cada, calcificações em 55,3%. Dos 41 pacientes (87,2%) com derivação ventriculoperitoneal (DVP), em 22 (53,7%) deles foram necessárias uma a sete revisões/paciente (média=3). A evolução foi satisfatória em 51,1% e fatal em 31,9%. Conclui-se que a hidrocefalia é mais comum no sexo masculino em idade produtiva, tendo a HIC, CEF, MN e PSI como manifestações freqüentes e que, a necessidade de revisões de DVP, piora o prognóstico.Cefaléias primárias: abordagem diagnóstica por médicos não-neurologistas10.1590/S0004-282X20070004000262024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZGaldino, Gilma SerraAlbuquerque, Tales Iuri Paz eMedeiros, Jovany Luís Alves de
<em>Galdino, Gilma Serra</em>;
<em>Albuquerque, Tales Iuri Paz E</em>;
<em>Medeiros, Jovany Luís Alves De</em>;
<br/><br/>
OBJETIVO: Avaliar o conhecimento do diagnóstico e conduta de médicos não-neurologistas quanto às cefaléias primárias. MÉTODO: 91 médicos foram solicitados a diagnosticar e estabelecer condutas em três histórias de pacientes com características clínicas de migrânea sem aura (MSA), cefaléia do tipo tensional crônica (CTTC) e migrânea com aura (MCA), elaboradas de acordo com a Classificação Internacional das Cefaléias - 2ª Edição (CIC-II). RESULTADOS: MSA: dois profissionais (2,2%) fizeram o diagnóstico correto, 54 (59,3%) diagnosticaram migrânea sem especificar o subtipo. CTTC: 15 médicos (16,5%) diagnosticaram cefaléia de tensão sem especificar o subtipo. MCA: 26 (28,6%) fizeram o diagnóstico de migrânea e apenas um médico (1,1%) fez o diagnóstico correto do subtipo. Dezesseis médicos (17,6%) afirmaram conhecer a CIC-II. CONCLUSÃO: A maioria dos médicos não-neurologistas desconhece os critérios utilizados para diagnóstico e classificação das formas mais freqüentes de cefaléias primárias.Liver transplantion in a patient with rapid onset parkinsonism-dementia complex induced by manganism secondary to liver failure10.1590/S0004-282X20070004000272024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZFabiani, GiorgioRogacheski, EnioWiederkehr, Júlio CésarKhouri, JussaraCianfarano, Andréa
<em>Fabiani, Giorgio</em>;
<em>Rogacheski, Enio</em>;
<em>Wiederkehr, Júlio César</em>;
<em>Khouri, Jussara</em>;
<em>Cianfarano, Andréa</em>;
<br/><br/>
Bilateral and symmetric globus-pallidus hyperintensities are observed on T1-weighted MRI in most of the patients with chronic liver failure, due to manganese accumulation. We report a 53-year-old man, with rapid onset parkinsonism-dementia complex associated with accumulation of manganese in the brain, secondary to liver failure. A brain MRI was performed and a high signal on T1-weighted images was seen on globus-pallidus, as well as on T2-weighted images on the hemispheric white-matter. He was referred to a liver-transplantation. The patient passed away on the seventh postoperative day. Our findings support the concept of the toxic effects of manganese on the globus-pallidus. The treatment of this form of parkinsonism is controversial and liver-transplantation should not be considered as first line treatment but as an alternative one.The value of brainstem evoked potential in clinical decision of a patient with hypoxic-ischemic encephalopathy10.1590/S0004-282X20070004000282024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZPinto, Anna Lecticia R.Costa, Franciele C.S.
<em>Pinto, Anna Lecticia R.</em>;
<em>Costa, Franciele C.s.</em>;
<br/><br/>
Establishing a prognosis for hypoxic-ischemic encephalopathy during the neonatal period is extremely difficult, as the neuroplasticity of the developing brain makes it almost impossible to measure the affected area. This case report describes a newborn with severe perinatal asphyxia and neonatal neurological syndrome including absent suck reflex. Normal brainstem auditory evoked potential led the diagnosis towards a transitory dysfunction of deglutition, and the subject received daily stimulation in the hospital environment. Suck developed satisfactorily by day of life 30 and the patient was released without having to be tube fed. Neurophysiologic tests can be of value in the clinical decisions and analysis of functional prognosis of patients with hypoxic-ischemic encephalopathy.De Morsier syndrome associated with periventricular nodular heterotopia: case reporte10.1590/S0004-282X20070004000292024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZSpinosa, Mônica JaquesLiberalesso, Paulo Breno NoronhaVieira, Simone CarreiroLöhr Júnior, Alfredo
<em>Spinosa, Mônica Jaques</em>;
<em>Liberalesso, Paulo Breno Noronha</em>;
<em>Vieira, Simone Carreiro</em>;
<em>Löhr Júnior, Alfredo</em>;
<br/><br/>
INTRODUCTION: Septo-optic dysplasia (De Morsier syndrome) is defined as the association between optic nerve hypoplasia, midline central nervous system malformations and pituitary dysfunction. CASE REPORT: Third child born to nonconsanguineous parents, female, adequate pre-natal medical care, cesarean term delivery due to breech presentation, Apgar score 3 at the first minute and 8 at 5 minutes, symptomatic hypoglycemia at 18 hours. Neurological follow-up identified a delay in acquisition of motor and language developmental milestones. Epileptic generalized seizures began at 12 months and were controlled with phenobarbital. EEG was normal. MRI revealed agenesis of the pituitary stalk, hypoplasia of the optic chiasm and periventricular nodular heterotopia. Ophthalmologic evaluation showed bilateral optic disk hypoplasia. Endocrine function laboratory tests revealed primary hypothyroidism and hyperprolactinemia. CONCLUSION: The relevance of this case report relies on its uniqueness, since periventricular heterotopia had not been described in association with septo-optic dysplasia until 2006.Relief of primary cervical dystonia symptoms by low frequency transcranial magnetic stimulation of the premotor cortex: case report10.1590/S0004-282X20070004000302024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZAllam, NasserBrasil-Neto, Joaquim PereiraBrandão, PedroWeiler, FernandaBarros Filho, Jairo deTomaz, Carlos
<em>Allam, Nasser</em>;
<em>Brasil-Neto, Joaquim Pereira</em>;
<em>Brandão, Pedro</em>;
<em>Weiler, Fernanda</em>;
<em>Barros Filho, Jairo De</em>;
<em>Tomaz, Carlos</em>;
<br/><br/>
OBJECTIVE: To evaluate the effect of low-frequency repetitive transcranial magnetic stimulation (rTMS) on the symptoms of a patient with primary segmental dystonia (PSD). METHOD: 1200 TMS pulses at a frequency of 1Hz, over the premotor cortex, with an intensity of 90% of the motor threshold (MT), using an eight-shaped coil; a total of 5 sessions were carried out. RESULTS: A reduction of 50 percent in the neck subset of the Burke, Fahn and Marsden torsion dystonia scale (BFM) was observed in our patient. CONCLUSION: The reduction in the BFM scale supports the concept that rTMS of the premotor cortex may reduce specific motor symptoms in PSD.Chronic inflammatory demyelinating polyradiculoneuropathy in chronic graft-versus-host disease following allogeneic hematopoietic stem cell transplantation: case report10.1590/S0004-282X20070004000312024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZLorenzoni, Paulo JoséScola, Rosana HerminiaCarsten, Ana Lucila MoreiraTrentin, Ana PaulaTeive, Hélio A.G.Pasquini, RicardoWerneck, Lineu C.
<em>Lorenzoni, Paulo José</em>;
<em>Scola, Rosana Herminia</em>;
<em>Carsten, Ana Lucila Moreira</em>;
<em>Trentin, Ana Paula</em>;
<em>Teive, Hélio A.g.</em>;
<em>Pasquini, Ricardo</em>;
<em>Werneck, Lineu C.</em>;
<br/><br/>
The chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an unusual but important complication of hematopoietic stem cell transplantation (HSCT) rarely reported to date. We describe a 17-year-old woman with a diagnosis of acute myeloid leukemia due to Fanconi's anemia who was submitted to allogeneic HSCT and developed CIDP as part of graft-versus-host disease. Investigation showed high cerebrospinal fluid protein; electrophysiological studies revealed sensory-motor demyelinating polyradiculoneuropathy; muscle and nerve biopsy were compatible with CIDP.Rhabdoid choroid plexus carcinoma: a rare histological type10.1590/S0004-282X20070004000322024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZTena-Suck, Martha LiliaGómez-Amador, Juan LuisOrtiz-Plata, AlmaSalina-Lara, C.Rembao-Bojórquez, DanielVega-Orozco, Rosalba
<em>Tena-Suck, Martha Lilia</em>;
<em>Gómez-Amador, Juan Luis</em>;
<em>Ortiz-Plata, Alma</em>;
<em>Salina-Lara, C.</em>;
<em>Rembao-Bojórquez, Daniel</em>;
<em>Vega-Orozco, Rosalba</em>;
<br/><br/>
Primary central nervous system atypical teratoid/rhabdoid tumors mostly occur during early childhood and are almost invariably fatal. These tumors show similar histological and radiological features to primitive neuroectodermal tumor, meduloblastoma and choroid plexus carcinoma, but present different biological behaviors. We present the case of an 18 year-old man who presented headache, vomiting and ataxia. CT-scan and MRI revealed a posterior fossa tumor. A gross total resection was performed. An intraoperative study showed papillary-like tumors with large cells and mitotic features. Histological examination showed two different main growth patterns: solid sheets of undifferentiated polygonal cells with papillary features and rhabdoid cells. Immunohistochemically, these rhabdoid cells were positive for vimentin, epithelial membrane antigen, smooth-muscle actin, cytokeratin, S-100 protein, and glial fibrillary acidic protein. Electro-microscopically, the typical rhabdoid cells contained whorled bundles of intermediate filaments in their cytoplasm. A rhabdoid tumor is a clinicalpathological entity and emphasizes the necessity to distinguish this unique tumor from other pediatric central nervous system neoplasms. Cytopathological features, immunohistochemistry and electro-microscopy differential diagnoses are discussed.Dom Pedro I of Brazil and IV of Portugal epilepsy and peculiar behavior10.1590/S0004-282X20070004000332024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZGomes, Marleide da MotaChalub, Miguel
<em>Gomes, Marleide Da Mota</em>;
<em>Chalub, Miguel</em>;
<br/><br/>
We present medical issues related to Dom Pedro de Alcântara Bragança e Bourbon (1798-1834), first Emperor of Brazil. This is made by means of narrative revision on historical facts starting from primary and secondary sources. Dom Pedro presented familiar incidence of epilepsy. His seizures were relatively benign and scattered, supposedly started at the age of 13: idiophatic epilepsy with generalized tonic-clonic seizures only or juvenile myoclonic epilepsy. He also had behavioral disorder characterized by hypersexuality, agitation and impulsiveness. It could have facilitated his opportunistic behavior necessary of daring to transgress the conservatism of the Portuguese crown, to create the constitutional monarchism in Brazil and in Portugal.Aproximaciones lingüísticas a la afasiología en torno a la repetición10.1590/S0004-282X20070004000342024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZBordas, Lluis Barraquer
<em>Bordas, Lluis Barraquer</em>;
<br/><br/>
Las afasias son una patología del lenguaje y éste es un sistema de mediación cultural lógica, situado netamente por encima de lo meramente natural. Arranca de la función simbólica, que establece la distinción y el nexo entre significante y significado. Se establece, a grandes rasgos, una clasificación neurolingüística de las afasias, rechazando las expresiones inadecuadas de sensitiva o sensorial y motora. Se insiste particularmente aquí sobre la cuestión de la "repetición" en la semiología afásica, tanto en lo que se refiere a su pérdida como a su "exaltación". Ello conduce a una revisión de la mal llamada afasia "de conducción" y del "transcorticalismo".Síndrome das pernas inquietas: diagnóstico e tratamento. Opinião de especialistas brasileiros10.1590/S0004-282X20070004000352024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000Z
Este artigo contém as conclusões de reunião de 17-18 de novembro de 2006 do Grupo Brasileiro de Estudo em Síndrome das Pernas Inquietas (GBE-SPI) sobre diagnóstico e tratamento de SPI. Reiterou-se que se trata de condição de diagnóstico exclusivamente clínico, caracterizada por sensação anormal localizada, sobretudo, mas não exclusivamente, em membros inferiores, com piora noturna e alívio por movimentação da parte envolvida. Agentes terapêuticos com eficácia comprovada por estudos classe I são agonistas dopaminérgicos, levodopa e gabapentina enquanto que ácido valpróico de liberação lenta, clonazepam, oxicodona e reposição de ferro têm eficácia sugerida por estudos classe II. As recomendações do GBE-SPI para manejo de SPI primária são medidas de higiene do sono, suspensão de agentes agravantes de SPI, tratamento de comorbidades e agentes farmacológicos. Para estes as drogas de primeira escolha são agentes dopaminérgicos; segunda escolha são gabapentina ou oxicodona; e terceira escolha são clonazepam ou ácido valpróico de liberação lenta.Arquivos de neuro-psiquiatria 200610.1590/S0004-282X20070004000362024-03-19T20:31:12.227000Z2020-08-09T06:48:12.642000ZSpina-França, Antonio
<em>Spina-França, Antonio</em>;
<br/><br/>