Esclerose lateral amiotrófica esporádica: critérios diagnósticos

Godoy, José Maurício; Oliveira, Marcelo A. R. de; Moraes Neto, João B. Mascarenhas de; Balassiano, Salim L.; Montagna, Nádia; Pinto, José Ricardo; Skacel, Michael

doi:10.1590/S0004-282X1993000200015

Resumos

Os autores apresentam os casos de dois enfermos com diagnóstico inicial de esclerose lateral amiotrófica e que, após investigação detalhada, tiveram-no afastado. Chamam a atenção para a necessidade de investigação cuidadosa em todos os pacientes com suspeita clínica da doença e propõem um protocolo para ser aplicado em todos os casos.

esclerose lateral amiotrófica; critérios diagnósticos; diagnóstico diferencial

The authors report two cases of amyotrophic lateral sclerosis (ALS) misdiagnosis (a craniocervical junction disorder, and a cervical spinal cord ependymoma). They review some causes of ALS-like syndrome land propose a protocol to be adopted for the study of all patients who present clinical abnormalities suggesting ALS.

amyotrophic lateral sclerosis; diagnostic criteria; diagnosis

Esclerose lateral amiotrófica esporádica: critérios diagnósticos

Criteria for diagnosis of amyotrophic lateral sclerosis

José Maurício Godoy^I; Marcelo A. R. de Oliveira^II; João B. Mascarenhas de Moraes Neto^II; Salim L. Balassiano^III; Nádia Montagna^IV; José Ricardo Pinto^V; Michael Skacel^VI

^IProfessor Adjunto de Neurologia, Universidade Estadual do Rio de Janeiro (UERJ)

^IIMédico Residente do Hospital Universitário Pedro Ernesto (HUPE), UERJ

^IIIProfessor Assistente de Neurologia, UERJ

^IVProfessor Auxiliar de Anatomia Patológica, UERJ

^VMédico do Serviço de Neurocirurgia, HUPE-UERJ

^VIProfessor Auxiliar de Neurologia, UERJ

RESUMO

Os autores apresentam os casos de dois enfermos com diagnóstico inicial de esclerose lateral amiotrófica e que, após investigação detalhada, tiveram-no afastado. Chamam a atenção para a necessidade de investigação cuidadosa em todos os pacientes com suspeita clínica da doença e propõem um protocolo para ser aplicado em todos os casos.

Palavras-chave: esclerose lateral amiotrófica, critérios diagnósticos, diagnóstico diferencial.

SUMMARY

The authors report two cases of amyotrophic lateral sclerosis (ALS) misdiagnosis (a craniocervical junction disorder, and a cervical spinal cord ependymoma). They review some causes of ALS-like syndrome land propose a protocol to be adopted for the study of all patients who present clinical abnormalities suggesting ALS.

Key words: amyotrophic lateral sclerosis, diagnostic criteria, diagnosis.

Full text available only in PDF format.

Texto completo disponível apenas em PDF.

Aceite: 09-setembro-1992.

Dr. José Maurício Godoy Rua Ozório Duque Estrada 74/902 B 22451-170 Rio de Janeiro RJ Brasil.

1. Bady B, Vial C, Brudon F, Lapras J, Kopp N, Trillet M. Neuropathies périphériques simulant une sclerose latérale amyotrophique au cours des gammapathies. Rev Neurol (Paris) 1988, 144:710-715.
2. Belsh JM, Schiffman PL. Misdiagnosis in patients with amyotrophic lateral sclerosis. Arch Intern Med 1990, 150:2301-2305.
3. Boothby JA, De Jesus PV, Rowland LP. Reversible forms of motor neuron disease (lead neuropathy). Arch Neurol 1974, 31:18-23.
4. Einstein ER, Mac Rae D. Spinal fluid analysis in amyotrophic lateral sclerosis. In Norris FH, Kurltand LT (eds): Motor neuron diseases: research on ALS and related disorders. New York: Grune & Stratton, 1969, p 175-178.
5. Evans BK, Fagan C, Arnold T, Dropcho EJ, Oh SJ. Paraneoplastic motor neuron disease and renal cell carcinoma: improvement after nephrectomy. Neurology 1990, 40: 960-962.
6. Godoy JM, Skacel M, Balassiano SL, Neves JRM. Doença do neurônio motor: avaliação metabólica. Arq Neuro-Psiquiat (São Paulo) 1992, 50:74-79.
7. Greenberg JO. Neuroimaging of the spinal cord. Neurol Clin 1991, 9:679-704.
8. Kantarjian AD. A syndrome clinically resembling amyotrophic lateral sclerosis following chronic mercurialism. Neurology 1961, 11:639-644.
9. Kasdon DL. Cervical spondylotic myelopathy with reversible fasciculations in the lower extremities. Arch Neurol 1977, 34:774-776.
10. Kimura J. Diseases of the motor neuron. In Kimura J (ed): Electrodiagnosis in diseases of nerve and muscle: principles and practice. Philadelphia: Davis 1989, p 429-446.
11. King RB, Stoops WL. Cervical myelopathy with fasciculations in the lower extremities. J Neurosurg 1963, 20:948-952.
12. Lambert EH. Electromyography in amyotrophic lateral sclerosis. In Norris FH, Kurland LT (eds): Motor neuron diseases: research on ALS and related disorders. New York: Grune & Stratton, 1969, p 135-153.
13. Latov N. Plasma, cell dyscrasia and motor neuron diseease. In LP Rowland (ed): Human motor neuron diseases. New York: Raven Press, 1982, p 273-279.
14. Lee KS, Kelly DL. Amyotrophic lateral sclerosis and severe cervical spondylotic myelopathy in a patient with a posterior fossa arachnoid cyst: diagnostic dilemma. Southern Med J 1987, 80:1580-1583.
15. Mitchell DM, Olczak SA. Remission of a syndrome indistinguishable from motor neuron disease after resection of bronchial carcinoma. Br Med J 1979, 279:176-177.
16. Mitsumoto H, Hanson MR, Chad DA. Amyotrophic lateral sclerosis: recent advances in pathogenesis and therapeutic trials. Arch Neurol 1988, 45:189-202.
17. Parry GJ, Holtz SJ, Ben-Zeev D, Drori JB. Gammopathy with proximal motor axono-pathy simulating motor neuron disease. Neurology 1986, 36:273-276.
18. Patten BM, Engel NK. Phosphate and parathyroid disorders associated with the syndrome of amyotrophic lateral sclerosis. In Rowland LP (ed): Human motor neuron diseases. New York: Raven Press, 1982, p 181-200.
19. Rowland LP. Diverse forms of motor neuron diseases. In Rowland LP (ed): Human motor neuron diseases. New York: Raven Press, 1982, p 1-13.
20. Rowland LP. Surgical treatment of cervical spondylotic myelopathy: time for a controlled trial. Neurology 1992, 42:5-13.
21. Schold SC, Cho ES, Somasundarum M, Posner JB. Subacute motor neuronopathy: a remote effect of lymphoma. Ann Neurol 1979, 5:271-287.
22. Wilkinson M. Motor neuron disease and cervical spondylosis. In Norris FH, Kurland LT (ed): Motor neuron diseases: research on ALS and related disorders. New York: Grune & Stratton, 1969, p 130-134.
23. World Federation of Neurology. Newsletter. World Neurol 1990, 5:12.

Datas de Publicação

Publicação nesta coleção
19 Jan 2011
Data do Fascículo
Jun 1993

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

[1] 1. Bady B, Vial C, Brudon F, Lapras J, Kopp N, Trillet M. Neuropathies périphériques simulant une sclerose latérale amyotrophique au cours des gammapathies. Rev Neurol (Paris) 1988, 144:710-715.

[2] 2. Belsh JM, Schiffman PL. Misdiagnosis in patients with amyotrophic lateral sclerosis. Arch Intern Med 1990, 150:2301-2305.

[3] 3. Boothby JA, De Jesus PV, Rowland LP. Reversible forms of motor neuron disease (lead neuropathy). Arch Neurol 1974, 31:18-23.

[4] 4. Einstein ER, Mac Rae D. Spinal fluid analysis in amyotrophic lateral sclerosis. In Norris FH, Kurltand LT (eds): Motor neuron diseases: research on ALS and related disorders. New York: Grune & Stratton, 1969, p 175-178.

[5] 5. Evans BK, Fagan C, Arnold T, Dropcho EJ, Oh SJ. Paraneoplastic motor neuron disease and renal cell carcinoma: improvement after nephrectomy. Neurology 1990, 40: 960-962.

[6] 6. Godoy JM, Skacel M, Balassiano SL, Neves JRM. Doença do neurônio motor: avaliação metabólica. Arq Neuro-Psiquiat (São Paulo) 1992, 50:74-79.

[7] 7. Greenberg JO. Neuroimaging of the spinal cord. Neurol Clin 1991, 9:679-704.

[8] 8. Kantarjian AD. A syndrome clinically resembling amyotrophic lateral sclerosis following chronic mercurialism. Neurology 1961, 11:639-644.

[9] 9. Kasdon DL. Cervical spondylotic myelopathy with reversible fasciculations in the lower extremities. Arch Neurol 1977, 34:774-776.

[10] 10. Kimura J. Diseases of the motor neuron. In Kimura J (ed): Electrodiagnosis in diseases of nerve and muscle: principles and practice. Philadelphia: Davis 1989, p 429-446.

[11] 11. King RB, Stoops WL. Cervical myelopathy with fasciculations in the lower extremities. J Neurosurg 1963, 20:948-952.

[12] 12. Lambert EH. Electromyography in amyotrophic lateral sclerosis. In Norris FH, Kurland LT (eds): Motor neuron diseases: research on ALS and related disorders. New York: Grune & Stratton, 1969, p 135-153.

[13] 13. Latov N. Plasma, cell dyscrasia and motor neuron diseease. In LP Rowland (ed): Human motor neuron diseases. New York: Raven Press, 1982, p 273-279.

[14] 14. Lee KS, Kelly DL. Amyotrophic lateral sclerosis and severe cervical spondylotic myelopathy in a patient with a posterior fossa arachnoid cyst: diagnostic dilemma. Southern Med J 1987, 80:1580-1583.

[15] 15. Mitchell DM, Olczak SA. Remission of a syndrome indistinguishable from motor neuron disease after resection of bronchial carcinoma. Br Med J 1979, 279:176-177.

[16] 16. Mitsumoto H, Hanson MR, Chad DA. Amyotrophic lateral sclerosis: recent advances in pathogenesis and therapeutic trials. Arch Neurol 1988, 45:189-202.

[17] 17. Parry GJ, Holtz SJ, Ben-Zeev D, Drori JB. Gammopathy with proximal motor axono-pathy simulating motor neuron disease. Neurology 1986, 36:273-276.

[18] 18. Patten BM, Engel NK. Phosphate and parathyroid disorders associated with the syndrome of amyotrophic lateral sclerosis. In Rowland LP (ed): Human motor neuron diseases. New York: Raven Press, 1982, p 181-200.

[19] 19. Rowland LP. Diverse forms of motor neuron diseases. In Rowland LP (ed): Human motor neuron diseases. New York: Raven Press, 1982, p 1-13.

[20] 20. Rowland LP. Surgical treatment of cervical spondylotic myelopathy: time for a controlled trial. Neurology 1992, 42:5-13.

[21] 21. Schold SC, Cho ES, Somasundarum M, Posner JB. Subacute motor neuronopathy: a remote effect of lymphoma. Ann Neurol 1979, 5:271-287.

[22] 22. Wilkinson M. Motor neuron disease and cervical spondylosis. In Norris FH, Kurland LT (ed): Motor neuron diseases: research on ALS and related disorders. New York: Grune & Stratton, 1969, p 130-134.

[23] 23. World Federation of Neurology. Newsletter. World Neurol 1990, 5:12.