RESUMO
BACKGROUND: To compare the retinal nerve fiber layer (RNFL) in eyes of patients with relapsing remitting multiple sclerosis (RRMS), neuromyelitis optica (NMO) and chronic relapsing inflammatory optic neuritis (CRION). METHODS: Evaluation of 62 patients with RRMS, NMO, and CRION in a cross-sectional study with spectral domain optical coherence tomography. RESULTS: A total of 124 eyes were evaluated (96 RRMS, 18 NMO, and 10 CRION). Frequency of optic neuritis for each disease was: 34% for RRMS, 84% for NMO, and 100% for CRION. Visual acuity and RNFL thickness were significantly worse in NMO and CRION eyes than in RRMS, but there were no differences between NMO and CRION eyes. A RNFL of 41 µm was 100% specific for optic neuritis associated with NMO and CRION when compared to RRMS. CONCLUSION: This study established RNFL values to differentiate optic neuritis of RRMS from NMO and CRION. Although similarities observed between NMO and CRION eyes might suggest that they are within the same disease spectrum, it is still recommended that these 2 conditions be differentiated on clinical grounds. Optical coherence tomography serves as an additional diagnostic tool and can be used to monitor disease progression.
Assuntos
Esclerose Múltipla/patologia , Neuromielite Óptica/patologia , Neurite Óptica/patologia , Retina/patologia , Células Ganglionares da Retina/patologia , Adulto , Estudos Transversais , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia de Coerência ÓpticaAssuntos
Ciclofosfamida/uso terapêutico , Imunossupressores/uso terapêutico , Neuromielite Óptica/tratamento farmacológico , Anti-Inflamatórios/uso terapêutico , Azatioprina/uso terapêutico , Avaliação da Deficiência , Seguimentos , Humanos , Metilprednisolona/uso terapêutico , Estudos RetrospectivosRESUMO
Clinical features of pontine infarction depend on the topography of vascular lesion and most remarkably sometimes the same topographic region can lead to different clinical syndromes (e.g., dorsal pontine tegmentum). In this report we describe an elderly patient with acute dorsal pontine infarction leading to a unique syndrome of bilateral horizontal gaze palsy and unilateral peripheral facial paralysis. We propose that this syndrome could be included as a part of a continuum that involves one-and-a-half syndrome, eight-and-a-half syndrome, and other variants of pontine tegmentum infarction.
Assuntos
Infartos do Tronco Encefálico/complicações , Infartos do Tronco Encefálico/patologia , Paralisia Facial/etiologia , Transtornos da Motilidade Ocular/etiologia , Ponte/patologia , Idoso , Transtornos Cerebrovasculares/complicações , Transtornos Cerebrovasculares/patologia , Lateralidade Funcional/fisiologia , Humanos , Imageamento por Ressonância Magnética , Masculino , Lobo Temporal/patologiaRESUMO
A case of an epidural granuloma due to Schistosoma mansoni compressing the spinal cord at T7-T9 is presented. The patient, a 35-year-old Brazilian man, started complaining of recurrent back pain since 2003. A magnetic resonance imaging (MRI) scan showed a large epidural mass extending from T7 to T9 and causing mild spinal cord compression. Through a bilateral laminectomy the bilharzioma was subtotally removed without significant bleeding. The histopathology confirmed the diagnosis of granuloma due to S. mansoni. The patient recovered completely. Although the MRI is nonspecific, this differential diagnosis should be included in homogeneous epidural lesions without bone involvement, more than ever in endemic countries or during the evaluation of travelers to those regions.