Comparison between a handheld ultrasound device and a traditional ultrasound for performing transcranial sonography in patients with Parkinson's disease.

OBJECTIVE: The aim of this study is to compare a portable ultrasound (US) device and a traditional US for performing transcranial ultrasonography (CCT) in patients with Parkinson's disease (PD). METHODS: This is a cross-sectional, observational, and analytical study. The study recruited a total of 129 individuals from two public hospitals in the city of Rio de Janeiro in a prospective and non-randomized manner between September 2019 and July 2021 as follows: group A with 31 patients with PD, group B with 65 patients with PD, and group C with 64 healthy individuals. Group A was used to collect data to establish the agreement analysis of the TCS measurements between the two devices. Groups B and C provided data for constructing the receiver operating characteristic curve for the handheld US. The subjects underwent the assessment of the transtemporal bone window (TW) quality, the mesencephalon area, the size of the third ventricle, and the substantia nigra (SN) hyperechogenicity area. RESULTS: There was a good agreement between the methods regarding the quality of the TW-Kappa concordance coefficient of 100% for the right TW and 83% for the left, the midbrain area-intraclass correlation coefficient (ICC) of 69%, the SN area ICC = 90% for the right SN and 93% for the left and the size of the third ventricle ICC = 96%. The cutoff point for the SN echogenic area in the handheld US was 0.20 cm2 . CONCLUSIONS: The handheld US is a viable imaging method for performing TCS because it shows good agreement with the measurements performed with traditional equipment, and the measurement of SN echogenic area for PD diagnosis presents good sensitivity and specificity.

Obsessive-compulsive symptoms among patients with blepharospasm and hemifacial spasm.

OBJECTIVE: The aim of this study was to compare the prevalence and the severity of different obsessive-compulsive disorder (OCD) symptoms reported by patients with blepharospasm (BSP) with those reported by patients with hemifacial spasm (HFS). We hypothesized that, since patients with BSP present a dysfunctional striato-thalamo-cortical circuitry, they would exhibit higher prevalence and/or greater severity of OCD symptoms than patients with HFS, a condition that results from peripheral irritation of the facial nerve. METHODS: Twenty-two patients with BSP and 31 patients with HFS were systematically evaluated by means of a sociodemographic and clinical questionnaire, the Mini International Neuropsychiatric Interview, the Obsessive-Compulsive Inventory-Revised, the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI) and the Mini Mental State Examination (MMSE). Diagnostic groups were compared using the Mann-Whitney U test for continuous variables and the Pearson's goodness-of-fit χ(2) test for categorical ones; Fisher's Exact Test was employed when indicated. Correlations between continuous variables were evaluated by means of Spearman coefficients. RESULTS: Patients with BSP and HFS were not significantly different in terms of sociodemographic characteristics and most neuropsychiatric features. Nevertheless, while checking was associated with shorter duration of BSP (Spearman's rho=-0.54; P=.01), hoarding correlated with a longer duration of HFS (Spearman's rho=0.40; P=.04). Length of abnormal movements did not correlate with the BDI, BAI and MMSE scores. CONCLUSIONS: The finding that the severity of different OCD symptoms did not differ between the BSP and HFS groups suggests that BSP may not interfere significantly with behavioral components of the striato-thalamo-cortical circuitry. However, the fact that OCD symptoms were found to follow different courses in distinct diagnostic groups deserves further study.

Tremor palatal: apresentaçäo de dois casos clínicos / Palatal tremor: report of 2 clinical cases

O tremor palatal é caracterizado clinicamente por contraçöes rítmicas e involuntárias dos músculos do palato mole. Existem dois tipos de tremor palatal: o sintomático, com o acometimento do músculo levantador do véu palatino por lesäo na via denteado-rubro-olivar e o tremor palatal essencial , em que há o envolvimento do músculo tensor do véu palatino, mas sem lesäo orgânica. Vários tratamentos säo propostos como o emprego de benzodiazepínicos, anticonvulsivantes, anticolinérgicos, precursores de neurotransmissores e toxina botulínica. Os autores apresentam uma breve revisäo a respeito desta desordem e discutem dois pacientes com tremor palatal.

Diffuse encephalic calcification: a case report

Os autores descrevem um caso de calcificaçäo encefálica difusa primária, näo familial, cuja primeira manifestaçäo fois disartria. Posteriormente, desenvolveu movimentos coreoatetósicos em mäos e face, discalculia e déficit de memória. A TC de crânio revelou calcificaçöes em hemisférios cerebrais e tranco cerebral

Segmental myoclonus and basilar artery giant aneurysm: case report

Os autores se referem ao caso de um homem de 70 anos, hipertenso e coronariopata, que apresentara, dois anos antes, hemiplegia direita como consequência de acidente vascular encefálico isquêmico. O exame neurológico, na vigência da internaçäo hospitalar, mostrou desorientaçäo espacial, instabilidade emociaonal (choro imotivado), hemiplegia com sinal de Babinski à direita e mioclona segmentar comprometendo o lábio superior e o palato (nistagno palatal) à direita. A tomografia computadorizada do crânio revelou aneurisma gigante da artéria basilar. Concluimos que a mioclonia segmentar poderia estar relacionada às lesöes isquêmicas no triângulo de Guillain-Mollaret

Siringomielia: revisäo da literatura e relato de caso / Syringomyelia: review of the literature and report of a case

Os autores fazem detalhada revisäo da literatura acerca de aspectos históricos, etiopatogênicos, clínicos, diagnósticos e terapêuticos da siringomiella. Apresentam um caso desta enfermidade, cujo diagnóstico foi confirmado por ressonância magnética