RESUMEN
PURPOSE: To evaluate the clinical features of pediatric patients with acute-onset, unilateral transient acquired blepharoptosis. METHODS: In this retrospective study, the clinical records of patients between April 2015 and June 2020 were reviewed for evaluation of demographic features, accompanying neurological and ophthalmologic manifestations, symptom duration, etiological cause, and imaging findings. Patients with congenital and acquired blepharoptosis with chronic etiologies were excluded. RESULTS: Sixteen pediatric patients (10 boys and 6 girls) with acquired acute-onset unilateral transient blepharoptosis were included in this study. The patients' mean age was 6.93 ± 3.16 years. The most commonly identified etiological cause was trauma in 7 patients (43.75%) and infection (para-infection) in 5 patients (31.25%). In addition, Miller Fisher syndrome, Horner syndrome secondary to neuroblastoma, acquired Brown's syndrome, and pseudotumor cerebri were identified as etiological causes in one patient each. Additional ocular findings accompanied blepharoptosis in 7 patients (58.33%). Blepharoptosis spontaneously resolved, without treatment, in all the patients, except those with Miller Fisher syndrome, neuroblastoma, and pseudotumor cerebri. None of the patients required surgical treatment and had ocular morbidities such as amblyopia. CONCLUSION: This study demonstrated that acute-onset unilateral transient blepharoptosis, which is rare in childhood, may regress without the need for surgical treatment in the pediatric population. However, serious pathologies that require treatment may present with blepharoptosis.
Asunto(s)
Blefaroptosis , Síndrome de Miller Fisher , Neuroblastoma , Seudotumor Cerebral , Masculino , Femenino , Niño , Humanos , Preescolar , Blefaroptosis/etiología , Blefaroptosis/cirugía , Estudios Retrospectivos , Seudotumor Cerebral/complicaciones , Síndrome de Miller Fisher/complicaciones , Neuroblastoma/complicacionesRESUMEN
A síndrome de Miller Fisher é uma desmielinização dos nervos cranianos e periféricos, gerando graves consequências para o paciente, como, por exemplo, redução ou ausência dos reflexos, paralisia do III, IV e VI nervos cranianos e ataxia. Este relato descreveu o caso de uma mulher de 51 anos, natural e procedente de Penápolis (SP), admitida em um hospital de Araçatuba (SP) com quadro de arreflexia, ataxia e oftalmoplegia. No contexto clínico, foi suspeitada a hipótese de síndrome de Miller Fisher e, assim, começou o processo de investigação, com base nos critérios diagnósticos. O caso foi diagnosticado como síndrome de Miller Fisher, e o tratamento teve início.
Miller Fisher Syndrome is a demyelinating disease affecting cranial and peripheral nerves, leading to severe problems to the patient, such as reduced or absent reflexes, III, IV and VI cranial nerves palsy, and ataxia. This report describes the case of a 51-year-old woman from the city of Penápolis, in the state of São Paulo, who was admitted to the hospital in the city of Araçatuba, in the same state, with ataxia, areflexia and ophthalmoplegia. In the clinical context, the suspicion of Miller Fisher Syndrome was raised, and then investigation ensued for the disease, based on the diagnostic criteria. After evaluation, Miller Fisher Syndrome was confirmed and treatment was started.
Asunto(s)
Humanos , Femenino , Persona de Mediana Edad , Síndrome de Miller Fisher/diagnóstico , Enfermedades Raras/diagnóstico , Parestesia/etiología , Blefaroptosis/etiología , Faringitis/complicaciones , Plasmaféresis , Síndrome de Miller Fisher/complicaciones , Síndrome de Miller Fisher/líquido cefalorraquídeo , Síndrome de Miller Fisher/rehabilitación , Paraparesia/etiologíaRESUMEN
Despite the wide literature describing the features of Guillain-Barré syndrome (GBS) in different populations worldwide, Colombian data are very scarce. We aim to characterize patients with GBS in a general hospital setting in Colombia. We conducted a retrospective chart review of GBS cases managed at the Hospital Universitario Fundación Santa Fe de Bogotá, from 2011 to 2016. Twenty-three patients were included. The most commonly reported symptoms were paresthesias (65%), pain (61%), proximal (22%) and distal (74%) limb weakness, and facial palsy (30%). 9% of patients had Fisher syndrome and 21% had other variants: Bickerstaff, pharyngeal-cervical-brachial pattern, and facial diplegia. There was a predominance of the demyelinating form (70%), with only 22% of patients presenting with the axonal variants. Our results are concordant with previous studies in Colombia.
Asunto(s)
Síndrome de Guillain-Barré/diagnóstico , Debilidad Muscular/etiología , Conducción Nerviosa/fisiología , Dolor/etiología , Parestesia/etiología , Adulto , Anciano , Colombia , Electromiografía , Femenino , Síndrome de Guillain-Barré/complicaciones , Síndrome de Guillain-Barré/fisiopatología , Humanos , Masculino , Persona de Mediana Edad , Síndrome de Miller Fisher/complicaciones , Síndrome de Miller Fisher/diagnóstico , Síndrome de Miller Fisher/fisiopatología , Debilidad Muscular/fisiopatología , Músculo Esquelético/fisiopatología , Dolor/fisiopatología , Parestesia/fisiopatología , Estudios Retrospectivos , Evaluación de SíntomasRESUMEN
El síndrome de Miller Fisher es una variedad clínica del síndrome de Guillain-Barré, que se caracteriza por oftalmoplejía, arreflexia y ataxia. Se presenta el caso de una paciente de 6 años de edad, atendida en el Hospital Pediátrico Docente Pepe Portilla de Pinar del Río, en noviembre de 2010; con antecedentes de salud anterior, que 5 días previos al inicio del cuadro tuvo una infección respiratoria alta aguda, seguida de un cuadro de debilidad bucofaríngea y facial, ataxia y debilidad muscular intensa de las extremidades. Se interconsulta con el servicio de Neurología, donde se constata diplejía facial periférica, parálisis del IV par izquierdo, ataxia e hiporreflexia; se le realizan varias investigaciones e ingresa en la Unidad de Cuidados Intensivos con el diagnóstico de síndrome de Miller Fisher. Se comienza el tratamiento con terapéuticocon, intacglobin y vitaminoterapia, logrando una evolución satisfactoria de la paciente a los 10 días de su ingreso en el servicio de UCI con regresión del cuadro...(AU)
Miller Fisher syndrome is a clinical variant of Guillain-Barré syndrome it is characterized by ophthalmoplegia, areflexia and ataxia. A six-year old female patient attended to Pepe Portilla Children Hospital, Pinar del Rio in November 2010; with past health records, who 5 days before the onset of the disorder suffered from an acute upper respiratory infection that was followed by a picture of buccopharyngeal and facial weakness, ataxia and acute muscular debility of the limbs. A referral to Neurology service verified peripheral facial diplegia, paralysis of the IV left pair, ataxia and hyporeflexia; several examinations were performed before admitting her to the Intensive Care Unit (ICU) with the diagnosis of Miller Fisher syndrome. The therapeutic treatment included intacglobin and vitamins, achieving a satisfactory progress; the patient was discharged from the ICU 10 days after her admission with a total regression of the clinical picture...(AU)
Asunto(s)
Humanos , Niño , Síndrome de Miller Fisher/complicaciones , Síndrome de Guillain-Barré/diagnóstico , InfeccionesRESUMEN
We report a case of Miller Fisher syndrome and bilateral demyelinating optic neuropathy suggesting the possible involvement of central nervous system in this syndrome. The optic neuritis was confirmed by visual evoked potential.
Asunto(s)
Enfermedades Desmielinizantes/diagnóstico , Potenciales Evocados Visuales , Síndrome de Miller Fisher/diagnóstico , Neuritis Óptica/diagnóstico , Adulto , Humanos , Masculino , Síndrome de Miller Fisher/complicaciones , Neuritis Óptica/complicacionesRESUMEN
Descreve-se um caso de síndrome de Miller Fisher associada a neuropatia óptica desmielinizante bilateral, confirmada pelo exame de potencial evocado visual, sugerindo possível comprometimento do sistema nervoso central nessa síndrome