RESUMO
INTRODUCTION: The question as to whether an electroencephalogram (EEG) needs to be carried out as a preliminary study in patients with dementia is currently the subject of some controversy. AIMS: Our aim was to determine the value of conventional and quantitative analysis of EEG recordings in the treatment of dementia. PATIENTS AND METHODS: The EEG recordings of patients diagnosed with a syndrome of dementia were analysed both visually and quantitatively (comparing them with patients with major depressive disorder). RESULTS: A total of 45 EEG traces were analysed -25 from patients with dementia and 20 with major depressive disorder-. The most significant finding was the number of abnormal recordings in each group, which was higher in the dementia group, with 19 abnormal recordings (76%) versus five in the depression group (25%). The difference was statistically significant (p = 0.001). The slow base rhythm and low voltage also differed notably between the two groups. The two groups displayed significant differences in both the frontal d and the temporal q rhythms (relative power), although the percentage was higher in patients with dementia. The posterior a rhythm was the variable with the greatest difference, and the percentage was higher in patients with depression. In absolute power, only the posterior a rhythm displayed a significant difference between the two groups, and was greater in the patients with depression. CONCLUSIONS: Performing an EEG in the initial treatment of patients with dementia is useful to distinguish it from other pathological conditions, and its quantitative analysis helps in the search for the focus.
Assuntos
Demência/fisiopatologia , Eletroencefalografia , Adulto , Idoso , Demência/diagnóstico , Transtorno Depressivo Maior/diagnóstico , Transtorno Depressivo Maior/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
The authors present the case of a 69 year old woman who developed bladder incontinence and confusion. A CT scan showed severe hydrocephalus and calcifications, prompting a ventriculoperitoneal shunt placement. On the day after operation the patient presented left hemifacial spasm. MR revealed a subarachnoid cysticercus rostral to the pons, and surgical excision was proposed. She refused surgery and was placed on prednisone. Brainstem auditory responses were absent on the left side 2 months after shunting and were still abnormal 53 months later. The hemifacial spasm disappeared 3 months after shunt placement and has not recurred in 5 years of follow-up.
Assuntos
Tronco Encefálico , Espasmo Hemifacial/etiologia , Hidrocefalia/etiologia , Neurocisticercose/complicações , Idoso , Anti-Inflamatórios não Esteroides/uso terapêutico , Tronco Encefálico/fisiopatologia , Calcinose/etiologia , Potenciais Evocados Auditivos do Tronco Encefálico , Feminino , Humanos , Hidrocefalia/cirurgia , Neurocisticercose/tratamento farmacológico , Neurocisticercose/fisiopatologia , Prednisona/uso terapêutico , Derivação VentriculoperitonealRESUMO
Although peripheral neuropathy is a fairly common finding in chronic arsenic poisoning, little is known about the acute effects of this metal on peripheral nerves. This report shows clinical and electrophysiological findings in a patient who developed peripheral neuropathy only three days after a high-dose ingestion of this metal due to a failed suicide attempt. We speculate that peripheral nerves and some cranial nerves can show not only clinical but also subclinical involvement that can only be detected by neurophysiological studies.
Assuntos
Intoxicação por Arsênico , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Doença Aguda , Adulto , Eletromiografia , Feminino , Humanos , Condução Nervosa , Doenças do Sistema Nervoso Periférico/diagnóstico , Doenças do Sistema Nervoso Periférico/fisiopatologia , Tentativa de SuicídioRESUMO
Creutzfeldt-Jakob disease (CJD) is one of a small group of the so-called spongiform encephalopathies. It is a rare transmissible disorder which is characterized by progressive and irreversible neurological damage. There are few reports where clinical manifestations are correlated with neurophysiologic and histopathologic findings. The present paper includes three cases of CJD where alterations in evoked potentials and brain mapping studies gave valuable information, especially in those where the clinical picture and the electroencephalogram were non-specific, we conclude that these alterations suggest that the classic histopathological changes in C-J disease involves both cortical and subcortical structures.
Assuntos
Síndrome de Creutzfeldt-Jakob , Biópsia , Encéfalo/patologia , Encéfalo/fisiopatologia , Mapeamento Encefálico , Córtex Cerebral/patologia , Síndrome de Creutzfeldt-Jakob/patologia , Síndrome de Creutzfeldt-Jakob/fisiopatologia , Eletroencefalografia , Potenciais Evocados Auditivos , Potenciais Somatossensoriais Evocados , Potenciais Evocados Visuais , Feminino , Humanos , Pessoa de Meia-IdadeRESUMO
Wernicke's encephalopathy is a disease that when not diagnosed in time, can lead to severe CNS damage and death. It is characterized by specific clinical and radiologic findings; however, there are few reports dealing with the usefulness of neurophysiologic studies in this syndrome. We present a patient with Wernicke's encephalopathy, diagnosed postmortem on autopsy, in whom the neurophysiologic studies showed abnormalities in all the different pathways tested. This suggests that EEG and evoked potentials may be useful tools in the diagnostic workup of this entity. We propose performing these tests when this syndrome is being considered.