RESUMO
OBJECTIVE: To demonstrate the different neuro-otologic clinical presentations of tuberculosis. STUDY DESIGN: Retrospective clinical analysis. RESULT: 83.3% of the cases of ear or central nervous system TB were without concomitant lung disease. 2 cases had primary infection in the central nervous system. The neuro-otologic manifestation was as follows: 85.7% sensorineural hearing loss; 42% polyneuropathy. 71.4% had granulation tissue. 2 had normal otoscopy. In 6 patients the histopathology and Ziehl Neelsen were confirmatory. One case was confirmed by the positive response to treatment with antituberculosis drugs. CONCLUSIONS: Tuberculosis has a wide variety of neurotologic manifestations from chronic otitis media cadres to vestibular, audiological and neurological manifestations as well as a large variability in imaging studies.
Assuntos
Otopatias/diagnóstico , Otopatias/microbiologia , Tuberculose do Sistema Nervoso Central/complicações , Tuberculose do Sistema Nervoso Central/diagnóstico , Adolescente , Adulto , Idoso , Antituberculosos/uso terapêutico , Otopatias/terapia , Feminino , Humanos , Masculino , Tuberculose do Sistema Nervoso Central/terapiaRESUMO
Bell's Palsy is the most frequent acute neuropathy of cranial nerves; it has been associated in various reports to herpes viruses. In a prospective study we searched the presence of DNA from five herpes viruses (HSV-1 and 2, VZV, EBV and HHV-6) in 79 patients at the acute phase of Bell's Palsy. Results were related with various parameters; age, gender and clinical outcome. We found the significant presence (pË0.001) of HSV-1 and VZV in 39% and 42% of patients. However, a large percentage of cases were negative. When comparisons were made between subgroups according to gender and age no differences were found with viral findings nor with clinical outcome of palsy, which was of clinical remission in most cases (78%). Our results suggest that herpes viruses might participate in the complex mechanisms of autoimmunity of Bell's Palsy but not as determinant etiological element.
Assuntos
Corticosteroides/uso terapêutico , Antivirais/uso terapêutico , Paralisia de Bell/tratamento farmacológico , Herpesvirus Humano 1/genética , Herpesvirus Humano 3/genética , Aciclovir/uso terapêutico , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/sangue , Autoimunidade , Paralisia de Bell/imunologia , Paralisia de Bell/patologia , Paralisia de Bell/virologia , Estudos de Casos e Controles , DNA Viral/sangue , DNA Viral/genética , Nervo Facial/efeitos dos fármacos , Nervo Facial/imunologia , Nervo Facial/patologia , Nervo Facial/virologia , Feminino , Herpesvirus Humano 1/patogenicidade , Herpesvirus Humano 2/genética , Herpesvirus Humano 3/patogenicidade , Herpesvirus Humano 4/genética , Herpesvirus Humano 6/genética , Humanos , Imunoglobulina G/sangue , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Indução de Remissão , Fatores Sexuais , Resultado do TratamentoRESUMO
La enfermedad de Meniere fue descrita desde finales del siglo pasado, las opciones terapéuticas son farmacológicas y quirúrgicas, reservándose esta última para los pacientes que no responden al tratamiento farmacológico. En este trabajo se presenta la experiencia en el tratamiento de 47 pacientes, con diagnóstico de enfermedad de Meniere a quienes se realizó descompresión de saco endolinfático durante los años de 1975 a 1994, con un seguimiento promedio de 5.7 años.Se muestran los resultados en el control de vértigo en 85 por ciento de los casos. La audición se preservó y no se demostró efecto del procedimiento sobre el acúfeno.