ABSTRACT
The establishment of neurology schools in Latin America during the late-nineteenth and early-twentieth centuries profoundly influenced the French neurology school. In the latter half of the nineteenth century, the neurology department at the Salpêtrière Hospital in Paris held a preeminent position as the global hub of neurology. Professor Jean-Martin Charcot, widely acclaimed as the father of modern neurology, was the most revered neurology professor of the nineteenth century. Many physicians from diverse countries across South America (notably Argentina, Uruguay, Peru, Brazil, and Colombia), the Caribbean (Cuba), and Mexico pursued specialized training in neurology under Charcot's tutelage, and even after his passing in 1893, they continued their training with his numerous disciples. As a result, nearly two centuries after the birth of Charcot, his enduring contributions to the field of neurology remain vibrantly influential, particularly in Latin America.
ABSTRACT
Huntington's disease (HD) is an inherited disease that leads to an inexorable progression of motor, cognitive and psychiatric disturbances. In the initial stages, the symptoms are not clearly disabling, and the patient may present a lack of awareness about the symptoms themselves, which we call anosognosia. However, anosognosia might not justify all passivity of the HD patient in face of the diagnosis. Patients may also experience the denial of illness, as a stage of grief, expected to happen in the face of the diagnosis of any neurodegenerative disorder. In addition, people with HD tend to be more apathetic, and more silent, in regular consultations. In the present article, the authors express a point of view, discussing the behavior of the HD patient, in which there is a multifactorial passivity, in the face of the diagnosis and of the disease itself. Having the proper knowledge of this situation may prepare the neurologist to better understand the patient and the evolution of the disease.
A doença de Huntington (DH) é uma doença hereditária que leva a uma progressão inexorável de distúrbios motores, cognitivos e psiquiátricos. Nos estágios iniciais, os sintomas não são claramente incapacitantes e há uma falta de consciência sobre os próprios sintomas, o que chamamos de anosognosia. No entanto, anosognosia pode não justificar toda a passividade do paciente de HD diante do diagnóstico. Os pacientes também podem vivenciar a negação da doença, como um estágio de luto, o que é esperado acontecer diante do diagnóstico de qualquer doença neurodegenerativa. Além disso, as pessoas com DH tendem a ficar mais apáticas, mais silenciosas, nas consultas regulares. No presente artigo, os autores expressam um ponto de vista, discutindo acerca do comportamento do paciente com DH, em que há uma passividade multifatorial, frente ao diagnóstico e diante da doença em si. Ter conhecimento sobre essa situação pode preparar o neurologista para entender melhor o paciente e a evolução da doença.
Subject(s)
Agnosia , Huntington Disease , Humans , Huntington Disease/psychologyABSTRACT
Abstract Huntington's disease (HD) is an inherited disease that leads to an inexorable progression of motor, cognitive and psychiatric disturbances. In the initial stages, the symptoms are not clearly disabling, and the patient may present a lack of awareness about the symptoms themselves, which we call anosognosia. However, anosognosia might not justify all passivity of the HD patient in face of the diagnosis. Patients may also experience the denial of illness, as a stage of grief, expected to happen in the face of the diagnosis of any neurodegenerative disorder. In addition, people with HD tend to be more apathetic, and more silent, in regular consultations. In the present article, the authors express a point of view, discussing the behavior of the HD patient, in which there is a multifactorial passivity, in the face of the diagnosis and of the disease itself. Having the proper knowledge of this situation may prepare the neurologist to better understand the patient and the evolution of the disease.
Resumo A doença de Huntington (DH) é uma doença hereditária que leva a uma progressão inexorável de distúrbios motores, cognitivos e psiquiátricos. Nos estágios iniciais, os sintomas não são claramente incapacitantes e há uma falta de consciência sobre os próprios sintomas, o que chamamos de anosognosia. No entanto, anosognosia pode não justificar toda a passividade do paciente de HD diante do diagnóstico. Os pacientes também podem vivenciar a negação da doença, como um estágio de luto, o que é esperado acontecer diante do diagnóstico de qualquer doença neurodegenerativa. Além disso, as pessoas com DH tendem a ficar mais apáticas, mais silenciosas, nas consultas regulares. No presente artigo, os autores expressam um ponto de vista, discutindo acerca do comportamento do paciente com DH, em que há uma passividade multifatorial, frente ao diagnóstico e diante da doença em si. Ter conhecimento sobre essa situação pode preparar o neurologista para entender melhor o paciente e a evolução da doença.
ABSTRACT
Rita Levi-Montalcini was a researcher in the field of neuroscience, Italian and Jewish in origin, who discovered the nerve growth factor and rightfully earned the 1986 Nobel Prize in Physiology or Medicine, alongside her collaborator Stanley Cohen. She was persecuted by the fascist dictatorship of Benito Mussolini and experienced gender and religious discrimination throughout her entire life. Despite these obstacles, she carried out her activities with diligence and grace, becoming a role model in the field. This paper reviews the life and career of Rita Levi-Montalcini.
Rita Levi-Montalcini foi uma pesquisadora no campo das neurociências, de origem Italiana e Judia, que descobriu o fator de crescimento neural e merecidamente recebeu o Prêmio Nobel de Fisiologia ou Medicina de 1986, em conjunto ao seu colaborador Stanley Cohen. Ela foi perseguida pela ditadura fascista de Benito Mussolini, e sofreu discriminação de gênero e religião durante sua vida inteira. A despeito desses obstáculos, sempre exerceu suas atividades com diligência e graça, tornando-se um exemplo nesse campo de estudo. O presente artigo faz uma revisão sobre a vida e carreira de Rita Levi-Montalcini.
Subject(s)
Fascism , Neurologists , Humans , Female , History, 20th Century , Nobel Prize , ItalyABSTRACT
Abstract Rita Levi-Montalcini was a researcher in the field of neuroscience, Italian and Jewish in origin, who discovered the nerve growth factor and rightfully earned the 1986 Nobel Prize in Physiology or Medicine, alongside her collaborator Stanley Cohen. She was persecuted by the fascist dictatorship of Benito Mussolini and experienced gender and religious discrimination throughout her entire life. Despite these obstacles, she carried out her activities with diligence and grace, becoming a role model in the field. This paper reviews the life and career of Rita Levi-Montalcini.
Resumo Rita Levi-Montalcini foi uma pesquisadora no campo das neurociências, de origem Italiana e Judia, que descobriu o fator de crescimento neural e merecidamente recebeu o Prêmio Nobel de Fisiologia ou Medicina de 1986, em conjunto ao seu colaborador Stanley Cohen. Ela foi perseguida pela ditadura fascista de Benito Mussolini, e sofreu discriminação de gênero e religião durante sua vida inteira. A despeito desses obstáculos, sempre exerceu suas atividades com diligência e graça, tornando-se um exemplo nesse campo de estudo. O presente artigo faz uma revisão sobre a vida e carreira de Rita Levi-Montalcini.
ABSTRACT
Professor Jean-Martin Charcot was the founder of clinical neurology and one of the prominent researchers in the field of hysteria in the 19th century. His book Les démoniaques dans l'art is a representation of hysterical symptoms in religion and religious art. This paper aims to discuss Charcot's descriptions of hysteria in religion and his "hysterical saints".
Professor Jean-Martin Charcot foi o fundador da neurologia clínica e um dos pesquisadores mais proeminentes no campo da histeria durante o século XIX. Seu livro Les démoniaques dans l'art é uma representação dos sintomas histéricos na religião e arte religiosa. Esse artigo objetiva discutir as descrições de Charcot de histeria na religião e seus "santos histéricos".
Subject(s)
Neurology , Saints , Humans , History, 19th Century , Hysteria/history , Neurology/history , FranceABSTRACT
Abstract Professor Jean-Martin Charcot was the founder of clinical neurology and one of the prominent researchers in the field of hysteria in the 19th century. His bookLes démoniaques dans l'art is a representation of hysterical symptoms in religion and religious art. This paper aims to discuss Charcot's descriptions of hysteria in religion and his "hysterical saints".
Resumo Professor Jean-Martin Charcot foi o fundador da neurologia clínica e um dos pesquisadores mais proeminentes no campo da histeria durante o século XIX. Seu livroLes démoniaques dans l'art é uma representação dos sintomas histéricos na religião e arte religiosa. Esse artigo objetiva discutir as descrições de Charcot de histeria na religião e seus "santos histéricos".
ABSTRACT
Language and its associated disorders have puzzled humanity since the dawn of civilization. The first descriptions of aphasia go back to classical antiquity. The Egyptians and Babylonians believed speech was a divine gift to mortals, and their descriptions of aphasia attributed these events to their Gods' anger and disfavour. The Edwin Smith Surgical Papyrus and the Hippocratic Corpus report several aphasia cases, relating this phenomenology to apoplexy, epilepsy, and other illnesses.
Subject(s)
Aphasia/history , Aphasia/pathology , Brain/pathology , Neurology/history , History, 19th Century , History, 20th CenturyABSTRACT
Background: Movement disorders are an infrequent presentation to stroke, and in this context, negative myoclonus is not among the most common movement disorders, hence we present a case of negative myoclonus secondary to thalamic stroke. Case: A 75 year old male presented with left central facial palsy and negative myoclonus on his left upper limb. He was submitted to a diagnostic workup, with evidence of a right thalamic stroke. He was started on Phenobarbital 50 mg and the movement disorder resolved. Conclusion: Given the relevance of cerebrovascular disease as a cause of morbidity and mortality, it is important to the clinician to be aware of the less typical presentations such as the observed in our case, in order to provide adequate care to the patient.
Subject(s)
Movement Disorders , Myoclonus , Stroke , Aged , Arm , Cerebral Infarction/complications , Cerebral Infarction/diagnostic imaging , Humans , Male , Myoclonus/complications , Myoclonus/drug therapy , Stroke/complications , Stroke/diagnostic imagingABSTRACT
BACKGROUND: Idiopathic normal pressure hydrocephalus (INPH) is characterized by gait disturbance, urinary incontinence and cognitive decline. Symptoms are potentially reversible and treatment is based on cerebrospinal fluid shunting. The tap test (TT) is used to identify patients that will benefit from surgery. This procedure consists of the withdrawal of 20 to 50 mL of cerebrospinal fluid (CSF) through a lumbar puncture (LP) after which the symptoms of the triad are tested. Improvement in the quality and speed of gait are already recognized but cognitive improvement depends on several factors such as tests used, the time elapsed after LP for re-testing, and the number of punctures. Serial punctures may trigger similar conditions as external lumbar drainage (ELD) to the organism. OBJECTIVE: This study aimed to identify how serial punctures affect cognition to increase the sensitivity of the test and consequently the accuracy of surgical indication. METHODS: Sixty-one patients with INPH underwent baseline memory and executive tests repeatedly following the 2-Step Tap Test protocol (2-STT - two procedures of 30 mL lumbar CSF drainage separated by a 24-h interval). The baseline scores of INPH patients were compared with those of 55 healthy controls, and with intragroup post-puncture scores of the 2-STT. RESULTS: The group with INPH had lower performance than the control group in all cognitive tests (RAVLT, Stroop, CFT, FAR-COWA, FAB, MMSE, orientation, mental control), except for the forward digit span test (p = 0.707). After conducting LP procedures, the Stroop test (words, colors and errors), RAVLT (stage A1, A6 and B1), and CFT (immediate and delayed R) scores were equal to those of the control group (p > 0.05). The INPH group presented significant improvement after the first puncture in MMSE (p = 0.031) and in the Stroop Test (points) (p < 0.001). After the second puncture, subjects improved in orientation, MMSE, RAVLT (B1), Stroop (points, words, errors) and CFT (IR). CONCLUSION: Progressive cognitive improvement occurred over the 2-STT and changes were more significant after the second LP in all cognitive domains except for RAVLT (A7). Encephalic alert system 'arousal' seems to participate in early improvements observed during 2-STT. The second LP increased the sensitivity of the drainage test to detect changes in cognitive variables, and consequently improved the quality of the method.
Subject(s)
Cognition/physiology , Drainage/methods , Hydrocephalus, Normal Pressure/psychology , Hydrocephalus, Normal Pressure/therapy , Mental Status and Dementia Tests , Spinal Puncture/methods , Aged , Aged, 80 and over , Female , Humans , Hydrocephalus, Normal Pressure/diagnosis , MaleABSTRACT
BACKGROUND: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations. OBJECTIVE: To review the literature on neurological complications of SARS-CoV-2 infection. METHODS: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020. RESULTS: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome. CONCLUSION: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.
Subject(s)
Coronavirus Infections/complications , Nervous System Diseases/complications , Pneumonia, Viral/complications , Ageusia/complications , Brain Diseases/complications , COVID-19 , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/physiopathology , Guillain-Barre Syndrome/complications , Humans , Myalgia/complications , Nervous System Diseases/physiopathology , Olfaction Disorders/complications , PandemicsABSTRACT
ABSTRACT Background: As the COVID-19 pandemic unfolds worldwide, different forms of reports have described its neurologic manifestations. Objective: To review the literature on neurological complications of SARS-CoV-2 infection. Methods: Literature search performed following systematic reviews guidelines, using specific keywords based on the COVID-19 neurological complications described up to May 10th, 2020. Results: A total of 43 articles were selected, including data ranging from common, non-specific symptoms, such as hyposmia and myalgia, to more complex and life-threatening conditions, such as cerebrovascular diseases, encephalopathies, and Guillain-Barré syndrome. Conclusion: Recognition of neurological manifestations of SARS-CoV-2 should be emphasized despite the obvious challenges faced by clinicians caring for critical patients who are often sedated and presenting other concurrent systemic complications.
RESUMO Introdução: À medida que a pandemia da COVID-19 se desenvolve em todo o mundo, diferentes tipos de publicações descreveram suas manifestações neurológicas. Objetivo: Revisar a literatura sobre complicações neurológicas da infecção por SARS-CoV-2. Métodos: A pesquisa bibliográfica foi realizada seguindo diretrizes de revisões sistemáticas, usando palavras-chave específicas baseadas nas complicações neurológicas da COVID-19 descritas até 10 de maio de 2020. Resultados: Foram selecionados 43 artigos, incluindo descrições que variam de sintomas comuns e inespecíficos, como hiposmia e mialgia, a condições mais complexas e com risco de vida, como doenças cerebrovasculares, encefalopatias e síndrome de Guillain-Barré. Conclusão: O reconhecimento das manifestações neurológicas da SARS-CoV-2 deve ser enfatizado apesar dos óbvios desafios enfrentados pelos clínicos que cuidam de pacientes críticos, muitas vezes sedados e apresentando outras complicações sistêmicas concomitantes.
Subject(s)
Humans , Pneumonia, Viral/complications , Coronavirus Infections/complications , Nervous System Diseases/complications , Brain Diseases/complications , Cerebrovascular Disorders/complications , Cerebrovascular Disorders/physiopathology , Coronavirus Infections , Guillain-Barre Syndrome/complications , Ageusia/complications , Pandemics , Myalgia/complications , Olfaction Disorders/complications , Nervous System Diseases/physiopathologyABSTRACT
This year marks the 75th year of publication of Arquivos de Neuro-Psiquiatria (ANP), the official journal of the Brazilian Academy of Neurology and one of the most important neuroscience journals in Latin America. ANP was initially edited by Oswaldo Lange, its founder, and subsequently by Antonio Spina-França Netto and, in recent years, by José Antonio Livramento and Luís dos Ramos Machado.
Subject(s)
Neuropsychiatry/history , Periodicals as Topic/history , Brazil , History, 20th Century , History, 21st Century , Periodicals as Topic/trendsABSTRACT
ABSTRACT This year marks the 75th year of publication of Arquivos de Neuro-Psiquiatria (ANP), the official journal of the Brazilian Academy of Neurology and one of the most important neuroscience journals in Latin America. ANP was initially edited by Oswaldo Lange, its founder, and subsequently by Antonio Spina-França Netto and, in recent years, by José Antonio Livramento and Luís dos Ramos Machado.
RESUMO Arquivos de Neuro-Psiquiatria (ANP), o periódico oficial da Academia Brasileira de Neurologia, completou 75 anos de atividades, reconhecido como um dos jornais de neurociências mais importante da América Latina. Nestes 75 anos de existência o ANP teve como editores os Professores Oswaldo Lange, o seu fundador, seguido por Antonio Spina-França Netto, e nos últimos anos, José Antonio Livramento e Luís dos Ramos Machado.
Subject(s)
History, 20th Century , History, 21st Century , Periodicals as Topic/history , Neuropsychiatry/history , Periodicals as Topic/trends , BrazilABSTRACT
Introdução: A doença de Parkinson (DP) trata-se de uma doença degenerativa de caráter insidioso, que acomete o sistema nervoso central trazendo mudanças biológicas, psicológicas e sociais. Apresenta sinais e sintomas motores, caracterizados por tremor, instabilidade postural, rigidez e bradicinesia. Objetivo: Avaliar a função auditiva central em pacientes com DP. Método: Estudo descritivo, prospectivo e transversal em que foram estudados 10 indivíduos com diagnóstico de DP, denominado grupo estudo (GE) e 10 indivíduos normo-ouvintes denominado grupo controle (GC) com média de 63.8 anos e (±SD) 5.96. Ambos os grupos realizaram avaliação otorrinolaringológica, avaliação audiológica convencional e o teste dicótico de dissílabos alternados (SSW). Resultados: Na análise quantitativa, o GC apresentou 80% de normalidade na escuta direita competitiva (DC) e 60% na esquerda competitiva (EC) em relação ao GE que apresentou 70% na DC e 40% na EC. Na análise qualitativa, o maior percentual de erros foi evidenciado no GE no efeito ordem. Os resultados demonstraram dificuldade na identificação de um som na coexistência de outro competitivo e na habilidade de memória. Conclusão: Observou-se diferença qualitativa e quantitativa no teste SSW entre os grupos estudados apesar dos estudos estatísticos não demonstrarem diferenças significativas. Ressalta-se a importância da avaliação do processamento auditivo central na contribuição dos procedimentos a serem realizados no acompanhamento terapêutico.
Introduction: Parkinson disease (PD) is a degenerating disease with a deceitful character, impairing the central nervous system and causing biological, psychological and social changes. It shows motor signs and symptoms characterized by trembling, postural instability, rigidity and bradykinesia. Objective: To evaluate the central hearing function in PD patients. Method: A descriptive, prospect and transversal study, in which 10 individuals diagnosed of PD named study group (SG) and 10 normally hearing individuals named control group (CG) were evaluated, age average of 63.8 and (SD) 5.96. Both groups went through otorhinolaryngological and ordinary audiological evaluations, and dichotic test of alternate disyllables (SSW). Results: In the quantitative analysis, CG showed 80% normality on competitive right-ear hearing (RC) and 60% on the competitive left-ear hearing (LC) in comparison with the SG that presented 70% on RC and 40% on LC. In the qualitative analysis, the biggest percentage of errors was evident in the SG in the order effect. The results showed a difficulty in identifying a sound when there is another competitive sound and in the memory ability. Conclusion: A qualitative and quantitative difference was observed in the SSW test between the evaluated groups, although statistical data does not show significant differences. The importance to evaluate the central hearing process is emphasized when contributing to the procedures to be taken at the therapeutic follow-up.
Subject(s)
Humans , Male , Female , Middle Aged , Aged, 80 and over , Audiometry , Hearing , Parkinson Disease , Auditory Perception , Hearing TestsABSTRACT
OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100%); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3%); there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. CONCLUSION: The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.
Subject(s)
Parkinson Disease/rehabilitation , Vestibular Diseases/rehabilitation , Aged , Exercise Therapy , Female , Geriatric Assessment , Humans , Male , Parkinson Disease/complications , Postural Balance , Sensation Disorders/complications , Sensation Disorders/rehabilitation , Surveys and Questionnaires , Vertigo/rehabilitation , Vestibular Diseases/complications , Vestibular Function TestsABSTRACT
OBJECTIVE: To evaluate the effectiveness of the vestibular rehabilitation (VR) exercises by means of an assessment before and after the application of the Brazilian version of the Dizziness Handicap Inventory (DHI) questionnaire. METHOD: Twelve patients were studied, the following procedures were carried out: anamnesis, otorhinolaryngological and vestibular evaluation, and the application of the DHI before and after the VR. RESULTS: Clinically resting tremors and subjective postural instability were the motor complaints most frequently associated with complaints of vertigo in 12 cases (100 percent); in the vestibular exam, all the patients presented abnormalities, frequently from the uni and bilateral peripheral vestibular deficiency syndromes in 10 cases (83.3 percent); there was significant improvement in the physical, functional and emotional aspects of the DHI after the completion of the VR. CONCLUSION: The VR following the Cawthorne and Cooksey protocol were shown to be useful in managing subjective complaints of several aspects evaluated in this protocol.
OBJETIVO: Avaliar a eficácia dos exercícios de reabilitação vestibular (RV) por meio de avaliação pré e pós-aplicação da versão brasileira do questionário Dizziness Handicap Inventory (DHI). MÉTODO: Estudou-se 12 pacientes e realizaram-se os seguintes procedimentos: anamnese, avaliação otorrinolaringológica, vestibular e aplicação do DHI pré e pós RV. RESULTADOS: Do ponto de vista clínico, o tremor de repouso e a instabilidade postural subjetiva foram às queixas motoras mais freqüentes associadas às queixas de vertigem em 12 casos (100 por cento); no exame vestibular, todos os pacientes apresentaram anormalidades, com freqüência das síndromes vestibulares periféricas deficitárias uni e bilaterais em 10 casos (83,3 por cento); houve melhora significativa dos aspectos físico, funcional e emocional do DHI após a realização da RV. CONCLUSÃO: A RV seguindo o protocolo de Cawthorne e Cooksey mostrou-se útil no manejo de queixas subjetivas de diversos aspectos avaliados neste protocolo.