Descargas epileptiformes periódicas lateralizadas em neurocisticercose

Carvalho-Filho, Pauzanes de; Arruda, Orlando Martins; Melo-Souza, Sebastião Eurico de

doi:10.1590/S0004-282X1989000100014

Resumos

Relatamos o caso de menina (10 anos) que apresentava síndrome psicorgânica subaguda associada a cefaléia, sem sinais patentes de hipertensão intracraniana. O diagnóstico de neurocisticercose foi firmado com base no exame do LCR. Foi tratada com praziquantel (50 mg/kg/dia por 21 dias) e apresentou PLEDs sobre o hemisfério esquerdo no dia seguinte ao término do tratamento. Posteriormente, passou a apresentar sinais de disfunção córtico-subcortical desse mesmo lado, nos EEG subseqüentes. A TC inicialmente normal confirmou, com a evolução, maior comprometimento do hemisfério esquerdo, embora houvesse disseminação parenquimatosa bilateral de cisticercos. Respondeu bem ao tratamento e evoluiu com recuperação total dos sintomas. Discutimos, também, aspectos neurofisiológicos dessa anormalidade eletrencefalográfica.

A case of a girl (10 years old) with a psycho-organic syndrome plus headache without signs of clear intracranial hypertension is related. The diagnosis of neurocysticercosis was made by CSF abnormalities. PLEDs over the left cerebral hemisphere were recorded at the first day after treatment with praziquantel (50mg/kg/day during 21 days). The first CT scan was normal and just after the treatment showed a prominent left cerebral hemisphere involvement, despite parenchymatous dissemination of cysticerci was bilateral. The treatment was successful and the patient became asymptomatic in the two years follow-up. The neurophysiologic aspects of this EEG abnormality is also discussed.

Descargas epileptiformes periódicas lateralizadas em neurocisticercose

Periodic lateralized epileptiform discharges in neurocysticercosis

Pauzanes de Carvalho-Filho^I; Orlando Martins Arruda^II; Sebastião Eurico de Melo-Souza^II

^IInstituto de Neurologia de Goiânia: Neurologista (Endereço atual: Rua Goncalves Dias, 676 - 78900 Porto Velho RO)

^IIInstituto de Neurologia de Goiânia: Neurologista

RESUMO

Relatamos o caso de menina (10 anos) que apresentava síndrome psicorgânica subaguda associada a cefaléia, sem sinais patentes de hipertensão intracraniana. O diagnóstico de neurocisticercose foi firmado com base no exame do LCR. Foi tratada com praziquantel (50 mg/kg/dia por 21 dias) e apresentou PLEDs sobre o hemisfério esquerdo no dia seguinte ao término do tratamento. Posteriormente, passou a apresentar sinais de disfunção córtico-subcortical desse mesmo lado, nos EEG subseqüentes. A TC inicialmente normal confirmou, com a evolução, maior comprometimento do hemisfério esquerdo, embora houvesse disseminação parenquimatosa bilateral de cisticercos. Respondeu bem ao tratamento e evoluiu com recuperação total dos sintomas. Discutimos, também, aspectos neurofisiológicos dessa anormalidade eletrencefalográfica.

SUMMARY

A case of a girl (10 years old) with a psycho-organic syndrome plus headache without signs of clear intracranial hypertension is related. The diagnosis of neurocysticercosis was made by CSF abnormalities. PLEDs over the left cerebral hemisphere were recorded at the first day after treatment with praziquantel (50mg/kg/day during 21 days). The first CT scan was normal and just after the treatment showed a prominent left cerebral hemisphere involvement, despite parenchymatous dissemination of cysticerci was bilateral. The treatment was successful and the patient became asymptomatic in the two years follow-up. The neurophysiologic aspects of this EEG abnormality is also discussed.

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Instituto de Neurologia de Goiânia - Praga T-18, 140 - 74610 Goiânia GO - Brasil

1. Bertolucci PHF, Silva AB - Descargas epileptiformes periódicas lateralizadas: aspectos clínicos e eletrencefalográficos. Arq Neuro-Psiquiat (São Paulo) 45:364, 1987.
2. Cannon WB, Rosenblueth A - The Problem of «irritative foci» in central nervous system. Clin Eletroenceph 17:VIII, 1986.
3. Chatrian GE, Shaw CM, Leffman H - The significance of periodic lateralized epileptiform discharges in EEG: an electrographic, clinical and pathological study. Electroenceph Clin Neurophysiol 17:177, 1964.
4. Janati A, Archer AL, Osteen PK - Coexistence of ectopic rhytms and periodic EEG pattern in anoxic encephalopathy. Clin Electroenceph 17:187, 1986.
5. Janati A, Chesser M, Husain MM - Periodic lacteralized epileptiform discharges (PLEDs): a possible role for metabolic factors in pathogenesis. Clin Electroenceph 17:36, 1986.
6. McKeever M, Holmes GL, Russman BS - Periodic lacteralized epileptiform discharges following a partial complex seizure. AM J EEG Technol 25:192, 1985.
7. Niedermeyer E, Lopes da Silva F - Electroencephalography. Basic Principles, Clinical Applications and Related Fields. Urban & Schwarzenberg, Baltimore, 1982.
8. Pe Benito R, Cracco JB - Periodic lacteralized epileptiform discharges in infants and children. Ann Neurol 6:47, 1979.
9. Suter C, Creveling JG Jr - Periodic lacteralized epileptiform discharges. Electroenceph Clin Neurophysiol 20:624, 1966.
10. Torres F - Epilepsy: electroclinical correlation as a function of age. In Henry CE (ed) : Current Clinical Neurophysiology : Update on EEG and Evoked Pontetials. Elsevier-North Holland, New York, 1980, pg 177.
11. Virmani V, Roy S, Kamala G - Periodic lacteralized epileptiform discharge in a case of diffuse cerebral cysticercosis. Neuropädiatrie 8:196, 1977.
12. Westmoreland BF, Klass DW, Sharbrough FW - Chronic periodic lateralized epileptiform discharges. Arch Neurol 48:494, 1986.

Datas de Publicação

Publicação nesta coleção
07 Jun 2011
Data do Fascículo
Mar 1989

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[1] 1. Bertolucci PHF, Silva AB - Descargas epileptiformes periódicas lateralizadas: aspectos clínicos e eletrencefalográficos. Arq Neuro-Psiquiat (São Paulo) 45:364, 1987.

[2] 2. Cannon WB, Rosenblueth A - The Problem of «irritative foci» in central nervous system. Clin Eletroenceph 17:VIII, 1986.

[3] 3. Chatrian GE, Shaw CM, Leffman H - The significance of periodic lateralized epileptiform discharges in EEG: an electrographic, clinical and pathological study. Electroenceph Clin Neurophysiol 17:177, 1964.

[4] 4. Janati A, Archer AL, Osteen PK - Coexistence of ectopic rhytms and periodic EEG pattern in anoxic encephalopathy. Clin Electroenceph 17:187, 1986.

[5] 5. Janati A, Chesser M, Husain MM - Periodic lacteralized epileptiform discharges (PLEDs): a possible role for metabolic factors in pathogenesis. Clin Electroenceph 17:36, 1986.

[6] 6. McKeever M, Holmes GL, Russman BS - Periodic lacteralized epileptiform discharges following a partial complex seizure. AM J EEG Technol 25:192, 1985.

[7] 7. Niedermeyer E, Lopes da Silva F - Electroencephalography. Basic Principles, Clinical Applications and Related Fields. Urban & Schwarzenberg, Baltimore, 1982.

[8] 8. Pe Benito R, Cracco JB - Periodic lacteralized epileptiform discharges in infants and children. Ann Neurol 6:47, 1979.

[9] 9. Suter C, Creveling JG Jr - Periodic lacteralized epileptiform discharges. Electroenceph Clin Neurophysiol 20:624, 1966.

[10] 10. Torres F - Epilepsy: electroclinical correlation as a function of age. In Henry CE (ed) : Current Clinical Neurophysiology : Update on EEG and Evoked Pontetials. Elsevier-North Holland, New York, 1980, pg 177.

[11] 11. Virmani V, Roy S, Kamala G - Periodic lacteralized epileptiform discharge in a case of diffuse cerebral cysticercosis. Neuropädiatrie 8:196, 1977.

[12] 12. Westmoreland BF, Klass DW, Sharbrough FW - Chronic periodic lateralized epileptiform discharges. Arch Neurol 48:494, 1986.