RESUMO
A 74 year-old woman with an early-stage senile dementia developed severe hypertonia and akinetic mutism two weeks after exposure to methane. A CT scan showed a diffuse area of decreased density extending symmetrically into the white matter of both cerebral hemispheres. Neuropathology revealed a senile dementia, Alzheimer's type, with severe non-hemorrhagic cerebral amyloid angiopathy and a diffuse spotty demyelination of the cerebral hemispheres sparing the U fibers, corpus callosum and internal capsules. The close resemblance between Grinker's myelinopathy, secondary to CO exposure or to other non-CO anoxic causes, and the leukoencephalopathy associated with cerebral amyloid angiopathy is emphasized.
Assuntos
Amiloidose/patologia , Encefalopatias/patologia , Encéfalo/patologia , Transtornos Cerebrovasculares/patologia , Hipóxia/complicações , Idoso , Doença de Alzheimer/complicações , Doença de Alzheimer/patologia , Amiloidose/complicações , Encefalopatias/complicações , Transtornos Cerebrovasculares/complicações , Feminino , Humanos , Metano/intoxicaçãoAssuntos
Encefalite Transmitida por Carrapatos/patologia , Meningoencefalite/patologia , Adulto , Animais , Anticorpos Antivirais/sangue , Especificidade de Anticorpos , Arbovírus/imunologia , Diagnóstico Diferencial , Eletromiografia , Encefalite Transmitida por Carrapatos/líquido cefalorraquidiano , Encefalite Transmitida por Carrapatos/diagnóstico , França , Humanos , Imunoglobulina G/sangue , Itália , Imageamento por Ressonância Magnética , Masculino , Meningoencefalite/líquido cefalorraquidiano , Meningoencefalite/diagnóstico , Poliomielite/diagnóstico , Romênia/etnologia , Espanha , ViagemRESUMO
The clinical, electrophysiological and histopathological features in seven cases of cisplatinum peripheral neuropathy are reported and compared with the literature data. The neuropathy appears for an average intake of 500 mg/m2 of DDP. The symptoms are those of a symmetric, distal, predominantly sensitive neuropathy of an axonal type with major involvement of proprioception. Neurological improvement is poor after withdrawal of the drug. A post mortem study performed in one case showed a degeneration of the posterior column in the cord and residual nodules of Nageotte in a lumbar spinal ganglion. The systematic study of the tendon reflexes and distal pallesthesia in subjects treated with the drug, may reveal the neuropathy before the onset of the most disabling symptoms (paresthesia, ataxia, pain, Lhermitte's sign).
Assuntos
Cisplatino/efeitos adversos , Doenças do Sistema Nervoso Periférico/induzido quimicamente , Adulto , Idoso , Cisplatino/administração & dosagem , Eletrofisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias/tratamento farmacológico , Sistema Nervoso/patologia , Doenças do Sistema Nervoso/diagnóstico , Doenças do Sistema Nervoso Periférico/patologiaRESUMO
We describe a patient with solitary plasmacytoma of the skull, in whom mononeuritis multiplex was the presenting manifestation. Some features of the POEMS syndrome (plasma cell dyscrasia with polyneuropathy, organomegaly, endocrinopathy, monoclonal [M] protein, skin changes), including thrombocytosis, were found. Muscle and nerve biopsies disclosed a small vessel hypersensitivity-type vasculitis and complement-fixing immune complex deposits in vessel walls. Removal of the plasmacytoma resulted in clinical improvement and clearance of the vasculitis and immune complex deposits.