RESUMO
In a prospective study of 57 patients with clinically definite, probable, or possible multiple sclerosis (MS), one-half of whom had a history of optic neuritis, retinal nerve fiber layer (RNFL) defects and the neuroretinal rim (NRR) area were quantitatively determined and compared with the visual evoked potential (VEP). There were abnormal VEP latencies in 63% of all patients (definite and probable = 68%, possible = 50%); local or diffuse RNFL defects in 54%, (definite and probable = 54%, possible = 50%); and an abnormally small NRR area in 30% (definite and probable = 32%, possible = 25%). Abnormalities in one or more of the VEP, RNFL, or NRR area occurred in 86% of all patients (definite and probable = 90%, possible = 75%), thus considerably increasing the yield of optic nerve abnormalities over that of the VEP alone. The predominance and extent of the diffuse RNFL defects, which are axonal abnormalities, suggest a more diffuse optic nerve pathology in MS than can be accounted for by a "plaque" pathology and indicate that extensive axonal loss commonly occurs in the optic nerves of MS.
Assuntos
Potenciais Evocados Visuais , Esclerose Múltipla/fisiopatologia , Disco Óptico/fisiopatologia , Retina/inervação , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atrofia Óptica/fisiopatologia , Nervo Óptico/fisiopatologia , Neurite Óptica/fisiopatologia , Estudos ProspectivosRESUMO
We report the seventh case of a self-limiting syndrome of brain, inner ear and retinal microangiopathy which affects adult women producing mild to moderate mental status and personality changes, mild pyramidal and cerebellar dysfunction, patchy and asymmetrical visual loss secondary to non-inflammatory retinal infarctions, and asymmetrical neurosensory hearing loss. There is no clinical or laboratory evidence of involvement beyond the brain, the eyes and the ears. Magnetic resonance imaging or brain biopsy in previously reported cases best outline the brain pathology: multiple microinfarcts. All cases have been treated with steroids or cyclophosphamide. The etiology is unknown but may be related to systemic lupus erythematosus.
Assuntos
Encefalopatias/etiologia , Perda Auditiva Neurossensorial/etiologia , Infarto/complicações , Doenças Retinianas/etiologia , Adulto , Feminino , Humanos , Transtornos da Personalidade/etiologia , Gravidez , Complicações Cardiovasculares na Gravidez , SíndromeRESUMO
Neoplasm is an uncommon cause of the parkinsonian syndrome. We are presenting three cases of intracranial tumors whose major manifestations included parkinsonism. Surgical treatment resulted in control of the extrapyramidal symptoms in two of our patients. Because no curative treatment is available for the vast majority of parkinsonian patients, early detection of an underlying neoplasm may offer a most rewarding outcome. Unilaterality of the symptoms, overwhelming dementia, or suspicion of a mass should lead to the performance of computed tomography.
Assuntos
Glioblastoma/complicações , Meningioma/complicações , Doença de Parkinson/etiologia , Idoso , Feminino , Glioblastoma/diagnóstico por imagem , Humanos , Masculino , Meningioma/diagnóstico por imagem , Pessoa de Meia-Idade , Radiografia , Tremor/etiologiaRESUMO
Five patients had cervical spondylotic myelopathy (CSM) with severe prorioceptive sensory loss in the upper and lower limbs. Despite an advanced age, each recovered considerable function following cervical laminectomy, in follow-up periods of 10 to 40 months. The role of newer methods of investigation including CT scanning, somatosensory evoked responses and nuclear magnetic resonance is discussed. The cause of the proprioceptive sensory loss in these patients cannot be definitively determined, but various ischemic and compressive lesions are discussed as possible pathogenetic mechanisms.
