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1.
J Postgrad Med ; 61(3): 206-8, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26119443

RESUMO

Primary lateral sclerosis (PLS) is one of the forms of motor neuron disease (MND), affecting only upper motor neurons. The diagnosis of PLS should be made on different diagnostic criteria, for example, Pringle or Gordon, but it is usually a diagnosis of exclusion. There are no characteristic findings in standard laboratory and electrophysiological assessment. We present details of a 31-year-old woman who had suffered from progressive paraparesis with right-side predominance. Conventional MRI of brain and spinal cord and diffusion tensor imaging (DTI) studies showed Hyperintense lesions in the upper part of the cervical spinal cord at the level C1 in lateral funicules, in the medulla oblongata at the pyramidal decussation and in the midbrain. Brain DTI revealed changes along the corticospinal tracts on fractional anisotropy (FA) maps. MRI of the thoracic spinal cord showed in T2-weighted images hyperintensive regions in the course of the lateral corticospinal tracts. This aided in PLS recognition.


Assuntos
Encéfalo/patologia , Imagem de Tensor de Difusão , Imageamento por Ressonância Magnética , Doença dos Neurônios Motores/diagnóstico , Tratos Piramidais/patologia , Medula Espinal/patologia , Adulto , Feminino , Humanos , Doença dos Neurônios Motores/patologia , Neurônios Motores/patologia
2.
Int Angiol ; 30(4): 375-9, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21747356

RESUMO

AIM: Different mechanisms (neural and intravascular) are thought to be important in the pathogenesis of Raynaud's phenomenon (RP). In a previous study we confirmed autonomic nervous system impairment in patients with primary RP, but the pathogenic role of peripheral nerves remained unclear. The aim of the current study was an electrophysiological analysis of peripheral nerves using both standard conduction velocity and the conduction velocity distribution (CVD) in patients with primary RP in order to investigate the causes of dysautonomia. METHODS: We examined 34 patients with primary RP and dysautonomia and 31 sex- and age-matched controls. Standard motor and sensory conduction tests in ulnar and peroneal (sural) nerves and a CVD test in the same nerves were performed. RESULTS: Clinically, none of the patients had motor symptoms, while 35.3% of them presented sensory neuropathy. Standard neurographic tests were within the normal limits except for the significant prolongation of mean sensory latency in both examined nerves. CVD revealed significant slowing of motor conduction velocity in all the conduction values, e.g. in the 10th, 50th, and 90th percentiles of velocity. There were no differences in the width of the velocity distribution in the patient group and controls. CONCLUSION: The results of CVD indicated the presence of generalized subclinical peripheral motor nerve impairment (subclinical polyneuropathy) in patients with primary RP and dysautonomia. Based on the present and previous studies, we conclude that the mechanism of autonomic dysfunction in primary RP is mixed, resulting from both central and peripheral neural abnormalities.


Assuntos
Condução Nervosa , Nervo Fibular/fisiopatologia , Disautonomias Primárias/fisiopatologia , Doença de Raynaud/fisiopatologia , Nervo Ulnar/fisiopatologia , Potenciais de Ação , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Disautonomias Primárias/diagnóstico , Doença de Raynaud/diagnóstico , Tempo de Reação , Sensação , Fatores de Tempo , Adulto Jovem
3.
Neuropediatrics ; 42(1): 4-6, 2011 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21557143

RESUMO

The aim of this study was to evaluate the prognostic value of Horner syndrome as an indicator of preganglionic injuries of the lower part of the brachial plexus. The study investigated 18 cases of children with perinatal brachial plexus injury and coexistent Horner syndrome. The following data sets were analyzed: the degree of severity of the brachial plexus injury, the results of imaging examinations, the intraoperative view, the kind of operative treatment and the resultant hand function. On the basis of a clinical material analysis, it was established that Horner syndrome accompanying upper and upper-middle brachial plexus injuries has no prognostic importance. In total injuries the presence of this syndrome is not a definite proof of preganglionic injury to the C8-Th1 roots of the spinal nerves.


Assuntos
Neuropatias do Plexo Braquial/complicações , Síndrome de Horner/complicações , Síndrome de Horner/diagnóstico , Paralisia/complicações , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Prognóstico
5.
Acta Neurol Scand ; 122(5): 360-6, 2010 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20078445

RESUMO

AIM: Holmes tremor (HT) is a combination of rest, postural and action tremor. A parallel dysfunction of cerebello-thalamic and nigrostriatal pathways seems necessary to produce this kind of tremor. We present the clinical and neuroimaging study verifying that hypothesis. MATERIAL AND METHODS: A total of 10 patients: five male, five female, fulfilling consensus criteria were included. Demographic, clinical and neuroimaging data (MRI = 9; CT = 1, SPECT with the use of 123-I-FP CIT: DaTSCAN in six patients to assess the presynaptic dopaminergic nigrostriatal system involvement, indices of asymmetry for ligand uptake for each striatum were calculated) were analyzed. RESULTS: Hemorrhage was the most frequent etiology and thalamus - the most commonly involved structure. Contrary to the previous reports, the visual assessment did not reveal remarkable interhemispheric differences of DaTSCAN uptake. Quantitative measurements showed only minimal differences. CONCLUSIONS: It is open to debate whether nigrostriatal pathway damage is crucial for the phenomenology of HT. Alternative hypothesis is presented that HT represents the heterogeneous spectrum of tremors with similar phenomenology, but different pathophysiology.


Assuntos
Encéfalo , Diagnóstico por Imagem/métodos , Tremor/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Tomografia Computadorizada por Raios X/métodos , Tropanos
6.
Int Angiol ; 28(2): 127-31, 2009 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19367242

RESUMO

AIM: The pathogenesis of Raynaud's phenomenon is still unclear. Neural and intravascular mechanisms are thought to be involved in the pathological process. The role of the autonomic nervous system is continually discussed, with particular attention to over-reactivity of the sympathetic part. The aim of this study was the clinical and electrophysiological analysis of autonomic nervous system function in patients with primary Raynaud's phenomenon. METHODS: Thirty four patients with primary Raynaud's phenomenon and 31 sex and age-matched controls were examined. Neurological examination, modified Low's Questionnaire, orthostatic and sustained handgrip tests, conduction velocity study in three nerves, sympathetic skin response (SSR), and heart rate variability (HRV) during deep breathing and at rest with the fast Fourier transform were performed. RESULTS: In the clinical examinations, 35.3% of the primary Raynaud's patients presented sensory neuropathy, but this was not confirmed in the standard conduction velocity tests. The modified Low's Questionnaire revealed dysautonomy in 82% of the patients. Autonomic regulation during the orthostatic and handgrip tests were within the normal limits. HRV at rest and the E/I ratio were significantly lower in the patient group than in the controls, while HRV spectrum analysis revealed the predominance of the low-frequency band in the patients. CONCLUSIONS: These results indicate the presence of sympathetic dysregulation and impairment of parasympathetic modulation of heart function in primary Raynaud's patients. The different cardiovascular and sudomotor functions are not affected to the same degree. These observations might support the theory of a central impairment of autonomic function in primary Raynaud's phenomenon. Peripheral nerve lesion as a coexisting cause of the observed dysautonomy remains uncertain.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Coração/inervação , Doença de Raynaud/fisiopatologia , Pele/inervação , Adulto , Pressão Sanguínea , Estudos de Casos e Controles , Estimulação Elétrica , Análise de Fourier , Força da Mão , Frequência Cardíaca , Humanos , Pessoa de Meia-Idade , Condução Nervosa , Exame Neurológico , Polônia , Tempo de Reação , Sensação , Inquéritos e Questionários , Fatores de Tempo , Adulto Jovem
7.
Pol Merkur Lekarski ; 10(56): 105-6, 2001 Feb.
Artigo em Polonês | MEDLINE | ID: mdl-11320574

RESUMO

The authors presented a rare case of chronic demyelinative polyneuropathy Guillain-Barré type in 49-year old woman with systemic lupus erythematosus. The diagnostic was based on electroneurographic examination and immunodiffusion of cerebrospinal fluid proteins. The authors indicated to the high effectiveness of high doses of immunoglobulins administrated intravenously after 3 months of the beginning of peripheral symptoms. At the onset of the disease the immunosuppression by use of prednisolone and cyclophosphamide was ineffective.


Assuntos
Síndrome de Guillain-Barré/tratamento farmacológico , Síndrome de Guillain-Barré/etiologia , Imunoglobulinas/administração & dosagem , Lúpus Eritematoso Sistêmico/complicações , Adulto , Líquido Cefalorraquidiano/metabolismo , Eletromiografia , Feminino , Síndrome de Guillain-Barré/líquido cefalorraquidiano , Síndrome de Guillain-Barré/diagnóstico , Humanos , Injeções Intravenosas , Lúpus Eritematoso Sistêmico/diagnóstico , Condução Nervosa , Nervo Fibular/fisiopatologia
8.
Neurol Neurochir Pol ; 33(1): 53-62, 1999.
Artigo em Polonês | MEDLINE | ID: mdl-10399724

RESUMO

In order to analyse the peripheral disturbances repetitive stimulation test (RNS Test) and nerve conduction studies were done in 33 patients, 19 women and 14 men (mean age 38.2 years), with at least probable diagnosis of multiple sclerosis. In RNS Test the mean CMAP amplitude was significantly lower in comparison to the control group without any difference after 30 seconds of effort. Significant decrementing response was revealed at low rate of stimulation (2Hz) and incrementing response during tetanic stimulation. Significant lower mean amplitude of M wave in all investigated nerves was found in motor nerve conduction velocity test. Abnormal mean distal latency and motor conduction velocity were less common. The mean results of sensory conduction velocity test were similar to the control group.


Assuntos
Eletromiografia/métodos , Esclerose Múltipla/complicações , Doenças do Sistema Nervoso Periférico/complicações , Doenças do Sistema Nervoso Periférico/diagnóstico , Adulto , Feminino , Humanos , Masculino , Nervo Mediano/fisiopatologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Nervo Fibular/fisiopatologia , Índice de Gravidade de Doença , Nervo Sural/fisiopatologia , Nervo Ulnar/fisiopatologia
9.
Pol Merkur Lekarski ; 7(40): 180-4, 1999 Oct.
Artigo em Polonês | MEDLINE | ID: mdl-10835909

RESUMO

The assessment of some aspects of cardiovascular and sudomotor system was performed in the group of patients with Alzheimer's disease. No one of patients complained of disturbances arising from these two parts of the vegetative system. The autonomic functions were evaluated by means of: clinical examination, heart rate variability tests at rest, measures of blood pressure and heart rate in supine and standing position and skin sympathetic response. At rest heart rate and its variability as well as blood pressure in the patients did not differ significantly from the results obtained in the healthy controls. On standing, changes in systolic blood pressure and heart rate were recorded in the controls, but not found in the patients. The majority of patients presented with abnormalities in skin sympathetic response: lack of response or prolongation of its latency. The results of motor and sensory nerve conduction studies excluded neuropathic changes in the patients. We conclude that autonomic disturbances accompanied Alzheimer's disease and were probably caused by damaged control mechanisms within the central vegetative system.


Assuntos
Doença de Alzheimer , Frequência Cardíaca/fisiologia , Transtornos Psicomotores/diagnóstico , Idoso , Doença de Alzheimer/complicações , Pressão Sanguínea/fisiologia , Feminino , Resposta Galvânica da Pele/fisiologia , Humanos , Masculino , Pessoa de Meia-Idade , Condução Nervosa/fisiologia , Transtornos Psicomotores/complicações
10.
Neurol Neurochir Pol ; 31(1): 113-22, 1997.
Artigo em Polonês | MEDLINE | ID: mdl-9235508

RESUMO

Electrically evoked blink reflex (BR) as a one of the non-invasive methods is used to diagnose function of central nervous system, specially of brainstem. It seems that this method is not fully appreciated in neurological practice. On the basis of literature and own experience the authors present typical pictures of BR on EMG analysis related to the lesions of respective parts of reflex arc and suprasegmental structures involving pyramidal and extrapyramidal tracts.


Assuntos
Piscadela/fisiologia , Doenças do Sistema Nervoso/diagnóstico , Encéfalo/fisiopatologia , Eletromiografia , Humanos
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