Denny-Brown and Pennybacker: 80 years after their pioneering article on electromyography, fibrillation and fasciculation.

We present a historical review, highlighting the role of Professor Derek Denny-Brown and doctor Joseph Buford Pennybacker in the development of current electromyography (EMG), of the 80 years since the publication of his original report in 1938 on fasciculation and fibrillation potentials and the subsequent studies describing most of the electrical changes necessary to perform and interpret the EMG.

Denny-Brown and Pennybacker: 80 years after their pioneering article on electromyography, fibrillation and fasciculation / Denny-Brown e Pennybacker: 80 anos da publicação de seu artigo pioneiro sobre eletromiografia, fibrilação e fasciculação

ABSTRACT We present a historical review, highlighting the role of Professor Derek Denny-Brown and doctor Joseph Buford Pennybacker in the development of current electromyography (EMG), of the 80 years since the publication of his original report in 1938 on fasciculation and fibrillation potentials and the subsequent studies describing most of the electrical changes necessary to perform and interpret the EMG.

RESUMO Os autores apresentam uma revisão histórica destacando o papel do Professor Derek Denny-Brown e do doutor Joseph Buford Pennybacker no desenvolvimento da eletromiografia atual, ao longo dos oitenta anos de seu artigo original em 1938, sobre potenciais de fasciculação e fibrilação, e os estudos subsequentes que descreveram a maioria das mudanças elétricas necessárias para realizar e interpretar EMG.

Visual Evoked Potentials in Neuromyelitis Optica Spectrum Disorders.

BACKGROUND: Neuromyelitis optica spectrum disorders (NMOSDs) are rare antibody-mediated disorders of the central nervous system, with a predilection for the spinal cord and optic nerves. The clinical utility of evoked potential recordings (EPs) has already been established for multiple sclerosis, in particular, that of the abnormal visual evoked potentials (VEP), a key criterion in the McDonald diagnostic criteria for MS. However, there have been few reports on EPs in patients with NMOSD. AIM: The aim of our study was to assess the possible involvement of the optical pathway through VEP responses in patients with NMOSD. METHODS: VEPs were prospectively performed in 13 patients with NMOSD. All the patients were recruited from the outpatient clinic of a demyelinating diseases center. The recording was done as recommended by the International Federation of Clinical Neurophysiology. RESULTS: We evaluated the eyes of 12 women with a mean age of 42 years and of one man who was 25 years old. In 6 of the examined eye samples, a response was not obtained, while in the remaining 20 eye samples, we found a significant increase in P100 latency without amplitude change. CONCLUSION: VEPs showed a significant increase in P100 latency. VEP assessment is a non-invasive, painless, fast, and low-cost exam that provides neurophysiological data for diagnosis of NMOSD.

Neurological Manifestations of Acquired Immunodeficiency Syndrome.

Objectives  To determine the neurological manifestations in AIDS patients with a recent diagnosis. Materials and methods A descriptive, retrospective study was carried out on 82 patients, admitted to the University Hospital in Curitiba for a period of 30 months, with positive serology for HIV, using the enzyme-linked immunosorbent assay (ELISA) method for diagnosis and confirmation. Results Of the 82 patients studied, 28 (34.1%) presented neurological manifestations; 16 were male (57.14%) and 12 female (42.85%). The age ranged from 22 to 79 years, with a median age of 35 years. Neurological manifestations were: headache (19.29%), motor deficit (19.29%), cranial nerve disorders (14.03%), epileptic seizures (10.52%), dementia (8.77%), coma (5.26%), ataxia (5.26%), mental confusion (5.26%), and tremor (3.5%). Cerebrovascular and neuroinfectious diseases (including neurotoxoplasmosis, bacterial and cryptococcal meningitis, and cerebral tuberculosis) were the most frequent diagnosis with 10 cases each (33.33%). Of the 28 patients, 10 (35.7%) died and 18 (64.28%) were discharged. Conclusion Based on the results found, it appears that one-third of AIDS patients with up to one year of diagnosis (34.14%) have some type of neurological manifestation, highlighting the importance of performing specific anamnesis and neurological examination in these patients.

In-Hospital Mortality From Cerebrovascular Disease.

Introduction Cerebrovascular disease (CVD) is the second most common cause of death. Despite the advances made in recent years with the introduction of specific treatment units and thrombolytics, CVD remains the leading cause of neurological hospitalization and adult disability. Objective Our objective is to determine the frequency and causes of early mortality, during hospitalization, of patients with acute CVD. Methods We conducted a retrospective, descriptive study of 704 patients treated for acute CVD at the Neurology Service of the Hospital in Curitiba, Brazil, over a period of three years, to whom the CVD Program protocol was applied. We checked the conditions at hospital discharge, obtaining the mortality rate and its causes. Results We studied 463 men and 241 women, over 14 years of age with an average of 64 years; 57 patients died. Of the 614 with ischemic CVD, nine males and four females died, establishing a mortality rate of 1.9%. Of the 90 patients with hemorrhagic CVD, 44 died: 26 male and 18 female. The main causes of death were arrhythmias, pneumonia with acute respiratory failure, acute myocardial infarction, and multiple organ failure. Conclusion We found no relationship between mortality and specific risk factors, except for age over 65 years. The low rate of deaths obtained in ischemic stroke reflects the multidisciplinary work involved in caring for patients with cerebrovascular disease in our center, which allows us to obtain results as low in mortality as those described in the literature.

Chorea as the First Manifestation of Cerebral Infarction.

Cerebrovascular disease (CVD), which usually manifests as a focal neurological deficit, is presented here as a movement disorder. This unusual manifestation corresponds to 1% of the CVDs and 8% of the striatal lesions. We report a 37-year-old right-handed woman who developed choreic movements as the first manifestation of an acute stroke. The computed tomography (CT) scan revealed a cortical/subcortical hypodense lesion in the right middle cerebral artery territory. This picture slowly improved and remitted completely after six weeks. Basal ganglia infarcts are crucial for the development of hemichorea, however, in spite of its frequency, movement disorders are disproportionally rare. In the majority of cases, the prognosis is good with spontaneous remission after two to four weeks.