RESUMO
Eighty consecutive neurological ambulatory patients with various symptoms are presented. All patients with a history of diabetes or alcoholism were excluded. The group was composed of 54 females and 26 males ranging in age from 16 to 67 years. Neurological examination showed at least one peripheral abnormal finding in all patients. Absence of Achilles reflexes, impairment of tactile and vibratory sensibility in the distal portions of the legs and dysesthesia were the most frequent alterations. All patients showed normal fasting blood sugar and were submitted to the oral glucose tolerance test. Some evidence of abnormal glucose tolerance was present in 41 patients (51.25% of the entire group). Thus, we suggest that polyneuritis, misinterpreted as late complication, is indeed an integral part of the syndrome of diabetes and may be its very first objective sign. In conclusion, it is assumed that all patients with evidence of objective polyneuritis should be thoroughly tested for abnormality of glucose tolerance.
Assuntos
Neuropatias Diabéticas/complicações , Polineuropatias/etiologia , Adolescente , Adulto , Idoso , Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/dietoterapia , Feminino , Teste de Tolerância a Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Polineuropatias/diagnósticoRESUMO
Oitenta pacientes que se submeteram a consulta neurológica ambulatorial por motivos diversos (excluídas polifagia, polidipsia, poliúria e modificaçäo na massa corporal) e nos quais o exame neurológico revelou uma polineurite foram submetidos a testes de tolerância à glicose, que resultaram anormais em 41 (todos tinham glicemia de jejum normal). A principal conclusäo a que chega o autor é de que oa polineurite é parte integrante do quadro geral do diabete, podendo representar uma de suas manifestaçöes mais iniciais e eventualmente preceder a detecçäo da própria alteraçäo metabólica pelo menos no que concerne às técnicas atualmente empregadas. O tratamento - limitado à dieta adequada - pode propiciar notória mellhora subjetiva
Assuntos
Adolescente , Adulto , Pessoa de Meia-Idade , Humanos , Masculino , Feminino , Neurite (Inflamação)/diagnóstico , Neuropatias Diabéticas/diagnóstico , Neuropatias Diabéticas/complicações , Neuropatias Diabéticas/dietoterapia , Teste de Tolerância a Glucose , Neurite (Inflamação)/etiologia , Exame NeurológicoRESUMO
The author reports the case of a 42-year-old woman who developed right peripheral facial paralysis and mixed polyneuritis in the course of an undiagnosed Chagas' disease. The clinical diagnosis could be confirmed by serological reactions for Chagas' disease. A likely relationship between chronic Chagas' disease, peripheral facial paralysis and mixed polyneuritis is discussed.
Assuntos
Doença de Chagas/complicações , Paralisia Facial/etiologia , Polineuropatias/etiologia , Adulto , Paralisia Facial/psicologia , Feminino , Humanos , Polineuropatias/psicologia , Transtornos PsicofisiológicosRESUMO
É apresentado o caso de uma paciente com 42 anos, que exibiu paralisia facial periférica direita, polineurite sensitivo-motora e síndrome psicofuncional. Raciocínio clínico foi engendrado, permitindo a formulaçäo diagnóstica da forma nervosa crônica da doença de Chagas, sendo esta posteriormente confirmada pela investigaçäo laboratorial
Assuntos
Adulto , Humanos , Feminino , Doença de Chagas/complicações , Paralisia Facial/complicações , Neurite (Inflamação)/complicações , Paralisia Facial/psicologia , Neurite (Inflamação)/psicologia , Transtornos PsicofisiológicosRESUMO
The author presents the case of a 68-year-old white woman who presented bilateral facial paralysis in the course of an undiagnosed diabetes mellitus. The paralysis remained stable for four years and as soon as the diabetes was treated, her symptoms improved.
Assuntos
Neuropatias Diabéticas , Paralisia Facial , Idoso , Feminino , HumanosRESUMO
The clinic case of a 21-year-old girl with 6 episodes of relapsing and alternating peripheral facial paralysis associated with plicated tongue is reported. She never had oedema of the lips or face. The author reviewed the literature regarding frequency, clinical features and etiology of recurrent facial palsy. The definitive etiology could not be demonstrated.
Assuntos
Paralisia Facial/complicações , Língua Fissurada/complicações , Adulto , Paralisia Facial/etiologia , Feminino , Humanos , RecidivaRESUMO
O autor relata o caso clínico de uma moça de 21 anos que apresentou 6 episódios de paralisia facial periférica (três de cada lado), no lapso de 4 anos, exibindo, ademais, língua escrotal. A literatura sobre paralisia recorrente é revisada, e uma discussäo acerca de eventuais fatores etiológicos é empreendida
Assuntos
Adulto , Humanos , Feminino , Paralisia Facial/complicações , Língua Fissurada/complicações , Paralisia Facial/etiologiaRESUMO
The author reports a case of a 28-year-old white girl who presented typical clonic spasm on the left side of the face without previous disorder of the facial nerve. No etiology could be determined. The treatment with carbamazepine has showed a very good response.
Assuntos
Carbamazepina/uso terapêutico , Músculos Faciais , Espasmo/tratamento farmacológico , Adulto , Feminino , HumanosRESUMO
The author reports the case of a 47-year-old man who developed an acute polyneuritis in the course of the chronic Chagas' disease. Neurological examination on admission forty-five days after onset showed total ptosis of the left eyelid without internal and external ophthalmoplegia. There was moderate diffuse weakness in the limbs. Tendon reflexes were depressed. Plantar responses were normal. The cerebrospinal fluid cell count and protein level were raised. The relationship between chronic Chagas' disease and peripheral polyneuritis is discussed.
Assuntos
Doença de Chagas/complicações , Polineuropatias/complicações , Doença Aguda , Blefaroptose/complicações , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
O autor apresenta o caso de paciente chagasico de 47 anos, que desenvolveu de modo agudo uma polineuropatia atipica, cujo elemento mais saliente consistiu de uma ptose palpebral unilateral completa. A nomenclatura e a conceituacao clinica da sindrome de Guillain-Barre-Strohl e de suas variantes sao discutidas, com maior enfase para sindrome de Miller Fisher.E discutida tambem uma eventual participacao da tripanosomiase no quadro neurologico
Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Blefaroptose , Doença de Chagas , Neurite (Inflamação)RESUMO
The authors report the case of a 64-year-old man who presented normal pressure hydrocephalus in the course of hypertensive and arteriosclerotic vasculopathy confirmed by postmortem examination. A blood clot was found on the central area of the left cerebellar hemisphere. The clinical features and the pathogenesis of normal pressure hydrocephalus and cerebellar hemorrhage are reviewed and discussed.
Assuntos
Doenças Cerebelares/complicações , Hemorragia Cerebral/complicações , Hematoma/complicações , Hidrocefalia de Pressão Normal/complicações , Hidrocefalia/complicações , Doenças Cerebelares/patologia , Hematoma/patologia , Humanos , Hidrocefalia de Pressão Normal/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
Os autores apresentam o caso de um paciente com hidrocefalia normotensa na vigencia de doenca hipertensiva, ambas confirmadas pela autopsia que, adicionalmente, revelou um hematoma cerebelar esquerdo.Uma discussao e empreendida em torno de varios aspectos da hidrocefalia con pressao normal e do hematoma cerebelar
Assuntos
Pessoa de Meia-Idade , Humanos , Masculino , Doenças Cerebelares , Hemorragia Cerebral , Hematoma , Hidrocefalia de Pressão NormalRESUMO
The authors review the literature about the cronic nervous form of Chagas' disease, directing their attention toward peripheral neurological aspects. Specifically, they analyse the results obtained from a "bind" research realized in a small community in the countryside of the state of Bahia, Brazil, where a high frequency of infection by Trypanosoma cruzi is reported. From 99 individuals examined, 50 showed a positive sorological test for Chagas' disease. The most frequent neurological findings in the total of 99 individuals were sensory loss and impairment of the deep reflexes. Among those with abolition of deep reflexes, there were 18 cases carrying a positive sorology for Chagas' disease, being that 15 from these 18 cases additionally presented a mild sensory deficit, characterizing a polyneuritic syndrome. In conclusion, they suggest that there is a neuritic form, as subdivision of a nervous form of Chagas' disease, particularly identified as a mixed polyneuritis.
Assuntos
Doença de Chagas/complicações , Polineuropatias/etiologia , Humanos , Polineuropatias/diagnósticoRESUMO
The results of a research realized in a small community in the countryside of the state of Bahia, Brazil, where there is high frequency of infection by Trypanosoma cruzi. are reported. By evaluation the neurological clinical examination of 99 individuals it was observed that the most frequent finding on those 50 patients with positive sorology there was a diminution of deep reflexes. Additionally, it was found that among the 20 patients in whom more than one altered deep reflex was present, in 18 cases there were concomitant sorological evidence of Chagas disease.
Assuntos
Doença de Chagas/complicações , Polineuropatias/etiologia , Adolescente , Adulto , Criança , Pré-Escolar , Testes de Fixação de Complemento , Feminino , Humanos , Masculino , Polineuropatias/diagnósticoRESUMO
A case of bilateral facial paralysis following meningococcal meningitis and herpes simplex infection is reported. The author discusses the differential diagnosis of bilateral facial nerve paralysis which included several diseases and syndromes and concludes by herpetic aetiology.