RESUMO
OBJECTIVE: The aim of this study was to compare the prevalence and the severity of different obsessive-compulsive disorder (OCD) symptoms reported by patients with blepharospasm (BSP) with those reported by patients with hemifacial spasm (HFS). We hypothesized that, since patients with BSP present a dysfunctional striato-thalamo-cortical circuitry, they would exhibit higher prevalence and/or greater severity of OCD symptoms than patients with HFS, a condition that results from peripheral irritation of the facial nerve. METHODS: Twenty-two patients with BSP and 31 patients with HFS were systematically evaluated by means of a sociodemographic and clinical questionnaire, the Mini International Neuropsychiatric Interview, the Obsessive-Compulsive Inventory-Revised, the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Mini Mental State Examination (MMSE). Diagnostic groups were compared using the Mann-Whitney U test for continuous variables and the Pearson's goodness-of-fit χ(2) test for categorical ones; Fisher's Exact Test was employed when indicated. Correlations between continuous variables were evaluated by means of Spearman coefficients. RESULTS: Patients with BSP and HFS were not significantly different in terms of sociodemographic characteristics and most neuropsychiatric features. Nevertheless, while checking was associated with shorter duration of BSP (Spearman's rho=-0.54; P=.01), hoarding correlated with a longer duration of HFS (Spearman's rho=0.40; P=.04). Length of abnormal movements did not correlate with the BDI, BAI and MMSE scores. CONCLUSIONS: The finding that the severity of different OCD symptoms did not differ between the BSP and HFS groups suggests that BSP may not interfere significantly with behavioral components of the striato-thalamo-cortical circuitry. However, the fact that OCD symptoms were found to follow different courses in distinct diagnostic groups deserves further study.
Assuntos
Blefarospasmo/epidemiologia , Blefarospasmo/psicologia , Espasmo Hemifacial/epidemiologia , Espasmo Hemifacial/psicologia , Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Centros Médicos Acadêmicos , Adulto , Idoso , Brasil/epidemiologia , Transtorno Depressivo/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Prevalência , Índice de Gravidade de DoençaRESUMO
BACKGROUND: Non-motor symptoms have been described in primary dystonia, but the results on cognitive impairment in this condition are discordant. Blepharospasm (BM) is a type of primary focal dystonia characterized by recurrent and involuntary eye blinking. Hemifacial spasm (HS), a condition with different pathophysiology, constitutes an adequate control group when investigating non-motor disturbances in BM. OBJECTIVE: To compare the performance of patients with BM and HS in the Frontal Assessment Battery (FAB). METHOD: Twenty-two patients with BM and 29 patients with HS were submitted to the FAB and the Mini-Mental State Examination (MMSE). FAB scores were compared between the two groups. Correlations between FAB and sociodemographic and clinical variables were calculated. RESULTS: BM group was not different from HS in relation to gender, age, length of symptoms, educational level and performance in the MMSE. FAB scores were also similar in both groups. FAB scores correlated negatively with age and positively with educational level and MMSE scores. CONCLUSION: Executive functioning as assessed by FAB is not altered in BM in comparison with HS.
Assuntos
Blefarospasmo/fisiopatologia , Função Executiva , Lobo Frontal/fisiopatologia , Espasmo Hemifacial/fisiopatologia , Blefarospasmo/psicologia , Demência/fisiopatologia , Distonia/fisiopatologia , Distonia/psicologia , Feminino , Espasmo Hemifacial/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estatísticas não ParamétricasRESUMO
BACKGROUND: Non-motor symptoms have been described in primary dystonia, but the results on cognitive impairment in this condition are discordant. Blepharospasm (BM) is a type of primary focal dystonia characterized by recurrent and involuntary eye blinking. Hemifacial spasm (HS), a condition with different pathophysiology, constitutes an adequate control group when investigating non-motor disturbances in BM. OBJECTIVE:To compare the performance of patients with BM and HS in the Frontal Assessment Battery (FAB). METHOD: Twenty-two patients with BM and 29 patients with HS were submitted to the FAB and the Mini-Mental State Examination (MMSE). FAB scores were compared between the two groups. Correlations between FAB and sociodemographic and clinical variables were calculated. RESULTS: BM group was not different from HS in relation to gender, age, length of symptoms, educational level and performance in the MMSE. FAB scores were also similar in both groups. FAB scores correlated negatively with age and positively with educational level and MMSE scores. CONCLUSION: Executive functioning as assessed by FAB is not altered in BM in comparison with HS.
INTRODUÇÃO: Alterações não-motoras são descritas na distonia primária, embora sejam conflitantes os resultados sobre prejuízo cognitivo nessa condição. Blefaroespasmo (BE) é um tipo de distonia primária focal caracterizada por contrações recorrentes e involuntárias das pálpebras. Espasmo hemifacial (EH), cuja fisiopatologia é distinta do BE, constitui bom grupo controle quando se investiga alterações não-motoras no BE. OBJETIVO: Comparar o desempenho de pacientes com BE e com EH na Bateria de Avaliação Frontal (BAF). MÉTODO: BAF e Mini-Exame do Estado Mental (MEEM) foram administrados a 22 pacientes com BE e 29 com EH. Os escores da BAF foram comparados entre os dois grupos. Correlações entre resultados na BAF e variáveis sócio-demográficas e clínicas foram calculadas. RESULTADOS: Os grupos BE e EH foram semelhantes quanto a gênero, idade, duração dos sintomas, escolaridade e desempenho no MEEM. Os escores dos dois grupos na BAF foram também similares, correlacionando-se negativamente com idade e positivamente com escolaridade e desempenho no MEEM. CONCLUSÃO: As funções executivas avaliadas pela BAF não estão alteradas no BE em relação ao EH.
Assuntos
Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Blefarospasmo/fisiopatologia , Função Executiva , Lobo Frontal/fisiopatologia , Espasmo Hemifacial/fisiopatologia , Blefarospasmo/psicologia , Demência/fisiopatologia , Distonia/fisiopatologia , Distonia/psicologia , Espasmo Hemifacial/psicologia , Testes Neuropsicológicos , Estatísticas não ParamétricasRESUMO
BACKGROUND: Blepharospasm (BS) is a form of central focal dystonia recently associated with psychiatric disorders, particularly obsessive and compulsive symptoms. Hemifacial spasm (HFS) represents a focal myoclonus with peripheral origin in the facial nerve. OBJECTIVE: To determine the frequency of obsessive and compulsive symptoms in patients with BS in comparison with patients with HFS. METHODS: 30 patients from each group (BS and HFS) followed by the botulinum toxin clinic at the HC-UFPR were evaluated using a structured interview based on the DSM-IV criteria and the Yale-Brown scale. Results were compared by the mean two-tailed t test. RESULTS: We found obsessive or compulsive symptoms in 20 (66.6%) patients with BE and 21 (70%) with HFS. Yale-Brown scale scores for each group were higher among BS patients; however, diferences were not statisticaly significant. CONCLUSION: Our study did not show a significant diference in the comparison of the prevalence of obsessive and compulsive symptoms among patients with BS and HFS.
Assuntos
Blefarospasmo/psicologia , Espasmo Hemifacial/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Comorbidade , Feminino , Humanos , Entrevista Psicológica , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/epidemiologia , Prevalência , Escalas de Graduação PsiquiátricaRESUMO
FUNDAMENTOS: Blefaroespasmo (BE) é uma forma de distonia focal central recentemente relacionada a desordens psiquiátricas, particularmente sintomas obsessivos e compulsivos. Espasmo hemifacial (EHF) representa uma forma de mioclonia com origem periférica, no nervo facial. OBJETIVO: Determinar a frequência de sintomas obsessivos e compulsivos em pacientes com BE em comparação com pacientes com EHF. MÉTODO: Foram avaliados 30 pacientes de cada grupo acompanhados no ambulatório de toxina botulínica do HC-UFPR, através de entrevista estruturada baseada nos critérios do DSM-IV e pela escala de Yale-Brown. Os resultados foram comparados pela média do teste de t de Student bicaudal. RESULTADOS: Observaram-se sintomas obsessivos ou compulsivos em 20 (66,6%) pacientes com BE e 21 (70%) pacientes com EHF. Os escores da escala de Yale-Brown em cada grupo foram maiores entre aqueles com BE, porém, as diferenças não foram estatisticamente significativas. CONCLUSÃO: Nosso estudo não evidenciou diferença significativa na comparação de prevalência de sintomas obsessivos e compulsivos entre pacientes com BE e EHF.
Assuntos
Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Blefarospasmo/psicologia , Espasmo Hemifacial/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Comorbidade , Entrevista Psicológica , Transtorno Obsessivo-Compulsivo/epidemiologia , Prevalência , Escalas de Graduação PsiquiátricaRESUMO
INTRODUCTION: Quality of life, a concept which has become increasingly important in recent years, refers to a patient's perception of himself in relation to his illness and its treatment. This is compared with the concept of quantity of life or survival. This approach is in keeping with the concepts of health of the World Health Organization. Hemifacial spasm is a disorder of movement with a prevalence of 7.4 and 14.5 per 100,000 men and women respectively. OBJECTIVE: To evaluate the quality of life of patients with hemifacial spasm, study the occurrence of depression and ascertain whether it correlates with the severity, response to treatment and muscle groups involved. PATIENTS AND METHODS: We present a cohort of 57 patients (average age 53.4 years) with hemifacial spasm, in whom the disorder had been present for an average of 3.7 years. RESULTS: It was found that in these patients the quality of life and index of depression were worse when the severity of the disease was greater, response to treatment poorer and there was generalized hemifacial paralysis, (p < 0.00000) for each parameter. The deterioration in quality of life was correlated with depression (correlation 0.6) for the criteria of severity and muscle groups involved, but not with the response to treatment (correlation 0.3). CONCLUSION: Hemifacial spasm significantly alters the quality of life of patients and is associated with depression. This should be taken into account when treating such patients.