RESUMO
Although gait and balance difficulties often occur together in Parkinson's disease (PD) patients, it is believed that they are actually two eparate symptoms. However, there are no simple tests to distinguish them. We have developed the self-administered Barrow Neurological Institute (BNI) question to distinguish between gait and balance issues in PD and it was tested in 102 consecutive PD patients. The responses were compared with those of the walking and balance question (item # 2.12) of the Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS), and the MDS-UPDRS motor examination and its subsets such as gait and postural stability (PS). Fifty-five patients reported balance difficulty on the BNI question and 64 reported walking and balance difficulty on the MDS-UPDRS question. Of the patients who reported balance difficulty on the BNI question, 74.5% had a PS score ≥2 and 25.4% fell at least three times per month. Of the patients who reported walking and balance difficulty on the MDS-UPDRS question, only 59.4% had a PS score ≥2 and only 10.9% fell three or more times per month. These statistically significant results suggest that the BNI question is better able to detect balance difficulty and its associated falls in PD and can be a supplement to the MDS-UPDRS or a stand-alone question to evaluate balance difficulty and its associated falls in PD.
Assuntos
Acidentes por Quedas , Transtornos Neurológicos da Marcha/diagnóstico , Transtornos Neurológicos da Marcha/etiologia , Doença de Parkinson/complicações , Equilíbrio Postural/fisiologia , Transtornos de Sensação/diagnóstico , Transtornos de Sensação/etiologia , Idoso , Idoso de 80 Anos ou mais , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Inquéritos e Questionários , Caminhada/fisiologiaRESUMO
Fungal infections of the central nervous system (CNS) have a high rate of morbidity and mortality caused by several factors. Most importantly, the last three decades have witnessed a rising prevalence of susceptible hosts from the growing numbers of organ transplants, chemotherapy patients, and intensive care unit hospitalizations. Knowledge of CNS fungal infections including their symptoms and signs, required diagnostic studies, and treatment methods is imperative for all neurologists. This article provides an overview of the clinical features and laboratory findings of the major mycoses affecting the CNS and a focus on their neurologic presentations.