ABSTRACT
INTRODUCTION: Congenital Zika virus syndrome is a distinct pattern of birth defects in fetuses infected by the Zika virus. It presents a broad clinical spectrum that includes occurrences of microcephaly, hypertonia, dysphagia, hyperexcitability, seizures, and arthrogryposis. Imaging findings show neuronal migration disorders. METHODOLOGY: Case reports have suggested that arthrogryposis has a neurogenic cause. We analyzed needle electromyography and nerve conduction examinations on 77 patients aged 2-24 months presenting highly probable congenital Zika virus syndrome, with or without arthrogryposis. RESULTS: All those with arthrogryposis presented with chronic muscle denervation in the electromyography examination. Similarly, children with single or reversible joint abnormalities at birth showed the same findings. Denervation in the paravertebral musculature was found in all of the children with diaphragmatic paralysis or thoracic deformities. CONCLUSIONS: We propose that congenital contractures associated with congenital Zika virus syndrome are caused by the malformation of upper and lower motor neurons during embryogenesis.
Subject(s)
Arthrogryposis , Microcephaly , Pregnancy Complications, Infectious , Zika Virus Infection , Zika Virus , Pregnancy , Infant, Newborn , Female , Child , Humans , Zika Virus Infection/complications , Zika Virus Infection/diagnosis , Zika Virus Infection/congenital , Arthrogryposis/diagnosis , Arthrogryposis/complications , Electromyography/adverse effects , Pregnancy Complications, Infectious/diagnosisABSTRACT
Fasciculations and cramps originate in the motor unit, a functional unit that includes the lower motor neuron and their innervated muscle fibres. Both are common complaints in outpatient practice. These symptoms can be secondary to neurological or medical pathology, presenting a broad differential diagnosis and a complex approach. Recent neurophysiological studies have increased the knowledge of their origin mainly in amyotrophic lateral sclerosis. The symptomatic management of fasciculations and cramps depends on their etiology and includes pharmacological and non-pharmacological treatments. This article aims to present an updated review of the most relevant aspects of physiopathology, clinical approach, and differential diagnosis of both phenomena.
Subject(s)
Humans , Fasciculation/diagnosis , Fasciculation/etiology , Fasciculation/therapy , Amyotrophic Lateral Sclerosis/complications , Amyotrophic Lateral Sclerosis/diagnosis , Amyotrophic Lateral Sclerosis/therapy , Electromyography/adverse effects , Motor Neurons/physiology , Muscle Cramp/diagnosis , Muscle Cramp/etiology , Muscle Cramp/therapyABSTRACT
Fasciculations and cramps originate in the motor unit, a functional unit that includes the lower motor neuron and their innervated muscle fibres. Both are common complaints in outpatient practice. These symptoms can be secondary to neurological or medical pathology, presenting a broad differential diagnosis and a complex approach. Recent neurophysiological studies have increased the knowledge of their origin mainly in amyotrophic lateral sclerosis. The symptomatic management of fasciculations and cramps depends on their etiology and includes pharmacological and non-pharmacological treatments. This article aims to present an updated review of the most relevant aspects of physiopathology, clinical approach, and differential diagnosis of both phenomena.
Subject(s)
Amyotrophic Lateral Sclerosis , Fasciculation , Amyotrophic Lateral Sclerosis/complications , Amyotrophic Lateral Sclerosis/diagnosis , Amyotrophic Lateral Sclerosis/therapy , Electromyography/adverse effects , Fasciculation/diagnosis , Fasciculation/etiology , Fasciculation/therapy , Humans , Motor Neurons/physiology , Muscle Cramp/diagnosis , Muscle Cramp/etiology , Muscle Cramp/therapyABSTRACT
Esta pesquisa avaliou por meio de análise eletromiográfica de superfície (EMGs) os efeitos terapêuticos de um dispositivo intrabucal sobre as atividades elétricas dos músculos masseter (porção superficial) e temporal (porção anterior), bilateralmente, em pacientes com síndrome de Down. A amplitude de abertura bucal, a intensidade de força mastigatória total (FMT) foram, também, investigadas por meio de paquímetro e transdutor de força. Adicionalmente, medidas antropométricas, incluindo índice de massa corporal (IMC), circunferências do pescoço (P) e abdominal (A) e relação cintura e quadril (RCQ) foram analisadas antes e após dois meses de terapia com DM. Dez pacientes com síndrome de Down, adultos, de ambos os gêneros, foram submetidos a uma terapia com um dispositivo mastigatório (DM). Os registros eletromiográficos foram realizados para avaliar a atividade elétrica dos músculos masseter e temporal, antes e após a terapia preconizada. Diante dos resultados obtidos, conclui-se que o DM promoveu diminuição das atividades elétricas do músculo temporal em condição de repouso da mandíbula e aumento da abertura bucal, conferindo um possível equilíbrio no sistema muscular mastigatório. A atividade elétrica na contração isométrica do músculo masseter e temporal foi aumentada, sugerindo uma maximização nas unidades motoras. A discreta redução do IMC e da RCQ indica, provavelmente, uma melhoria na distribuição de gordura corporal dos pacientes. Portanto, o DM colaborou para a melhoria do desempenho biomecânico da mastigação(AU)
This research evaluated the therapeutic effects of an intrabuccal device on the electrical activities of the masseter (superficial portion) and temporal (anterior portion) muscles, bilaterally, in patients with Down syndrome by means of surface electromyographic analysis (EMGs). The mouth opening amplitude and the total masticatory force intensity (FMT) were also investigated by means of a pachymeter and force transducer. In addition, anthropometric measurements, including body mass index (BMI), neck (P) and abdominal (A) circumference and waist and hip ratio (WHR) were analyzed before and after two months of DM therapy. Ten patients with Down syndrome, adults of both genders, underwent masticatory (DM) therapy. The electromyographic records were performed to evaluate the electrical activity of the masseter and temporal muscles, before and after the recommended therapy. In view of the obtained results, it was concluded that DM promoted a decrease in the electrical activities of the temporal muscle in a condition of rest of the mandible and increase of the buccal opening, conferring a possible balance in the muscular masticatory system. The electrical activity in the isometric contraction of the masseter and temporal muscle was increased, suggesting a maximization in the motor units. The discrete reduction in BMI and WHR probably indicates an improvement in patients' body fat distribution. Therefore, DM collaborated to improve the biomechanical performance of mastication (AU)