RESUMEN
Thirteen subjects with trigeminal neuralgia were treated with botulinum-A neurotoxin (BoNT/A) in an open-label pilot study. After BoNT/A, visual analog scale score, surface area of pain, and therapeutic coefficient were reduced in all patients and for all branch trigeminal nerves studied. Therefore, BoNT/A is an efficient treatment. There were no major side effects. A placebo-controlled clinical trial is needed to confirm these findings.
Asunto(s)
Toxinas Botulínicas Tipo A/administración & dosificación , Nervio Trigémino/efectos de los fármacos , Neuralgia del Trigémino/tratamiento farmacológico , Anciano , Analgésicos/uso terapéutico , Anticonvulsivantes/uso terapéutico , Blefaroptosis/inducido químicamente , Toxinas Botulínicas Tipo A/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neuropéptidos/antagonistas & inhibidores , Neuropéptidos/metabolismo , Neurotoxinas/administración & dosificación , Neurotoxinas/efectos adversos , Nociceptores/efectos de los fármacos , Nociceptores/fisiología , Dimensión del Dolor/efectos de los fármacos , Umbral del Dolor/efectos de los fármacos , Umbral del Dolor/fisiología , Proyectos Piloto , Células Receptoras Sensoriales/efectos de los fármacos , Células Receptoras Sensoriales/fisiología , Transmisión Sináptica/efectos de los fármacos , Transmisión Sináptica/fisiología , Resultado del Tratamiento , Nervio Trigémino/fisiopatología , Neuralgia del Trigémino/fisiopatologíaRESUMEN
We evaluated 44 patients with tics and Tourette's syndrome (TS) emphasising the age of onset of symptoms, sex, classification and localization of tics, associated symptoms and signs and comorbidities. Thirty-three patients (75.2%) had TS defined criteria whereas 10 (22.7%) had chronic motor and/or vocal tics. Simple motor tics were found in 43 cases (97.7%), mainly affecting the eyes (43.2%), mouth (43.2%), face (34.1%). Simple vocal tics occurred in 33 (75%). Coprolalia was found in just 6 cases (13.6%) and copropraxia in just 2 (4.5%). Obsessive compulsive disorder and/or symptoms were found in 26 cases (59.1%) and attention deficit in 17 (38.6%). Eighteen patients (40.9%) had other disorders, such as alcoholism, tabagism, drug abuse, affective disorders, anxiety, sleep and learning disorders. The data obtained are similar to those found by other authors. We highlight the low frequency of coprolalia, as well as the associated neuropsychiatric disorders.
Asunto(s)
Tics/complicaciones , Síndrome de Tourette/complicaciones , Adolescente , Adulto , Edad de Inicio , Trastorno por Déficit de Atención con Hiperactividad/complicaciones , Trastorno por Déficit de Atención con Hiperactividad/diagnóstico , Brasil/epidemiología , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Trastorno Obsesivo Compulsivo/complicaciones , Trastorno Obsesivo Compulsivo/diagnóstico , Estudios Retrospectivos , Tics/diagnóstico , Síndrome de Tourette/diagnósticoRESUMEN
Autosomal recessive hereditary spastic paraplegia (AR-HSP) associated with thin corpus callosum was recently described in Japan, and most families were linked to chromosome 15 q13-15. We report two patients from two different Brazilian families with progressive gait disturbance starting at the second decade of life, spastic paraparesis, and mental deterioration. One patient presented cerebellar ataxia. Magnetic resonance imaging (MRI) of the head of both patients showed a thin corpus callosum. AR-HSP with a thin corpus callosum is a rare disorder, mainly described in Japanese patients. We found only 4 Caucasian families with AR-HSP with thin corpus callosum described in the literature. Further studies including additional Caucasian families of AR-HSP with thin corpus callosum are required to delineate the genetic profile of this syndrome in occidental countries.