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Síndrome POEMS/patologia , Denervação , Diabetes Mellitus Tipo 2/etiologia , Ginecomastia/etiologia , Hepatomegalia/etiologia , Humanos , Hipertricose/etiologia , Masculino , Pessoa de Meia-Idade , Hipotonia Muscular/etiologia , Osteólise/etiologia , Síndrome POEMS/diagnóstico , Fenótipo , Esplenomegalia/etiologiaRESUMO
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Adulto , Masculino , Lactente , Feminino , Humanos , Córtex Motor , Transtornos dos Movimentos , Atrofia Muscular Espinal , Neurônios Motores , Braço , Doença Aguda , EncefaliteRESUMO
INTRODUCTION: Behçet's disease is a multisystemic illness in which neurological abnormalities are seen in 5-48% of cases. CLINICAL CASES: We present 3 patients (2 men and 1 women) diagnosed as having Behçet's disease, according to the criteria of the 'International Study Group for Behçet's Disease' of 1990. We describe the clinical findings in these patients, the results of investigations done (MR or CT, evoked potentials-PEV, PESS, PEATC-EEG, ECN, CSF and neuropsychological tests), their course and response to treatment with hyperimmune human gammaglobulim at a dose of 400 mg/kg body weight in 2 patients. All three patients had repeated episodes of meningitis and alterations of the cranial nerves; two patients had epileptic seizures and two had signs of cerebellar disorders and dementia at some time during their illness. One patient died and the other two survived with severe disabilities. Cranial CT showed a cerebral infarct in one patient; evoked potentials showed axon damage in the two patients in whom this was studied. In the only patient in whom ECN was done, signs of axonal polyneuropathy were found. In all three patients there was pleocytosis in the CSF. In the patients in whom hyperimmune human gammaglobulin was given, the results were: one improved after this treatment; in the other there was clinical deterioration, but this was considered to be secondary to a curettage done the day before. CONCLUSION: The presence of neurological findings in Behçet's disease not caused by cerebral vein thrombosis worsens the prognosis of these patients.
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Síndrome de Behçet/fisiopatologia , Adulto , Potenciais Evocados , Feminino , Humanos , Masculino , Testes Neuropsicológicos , PrognósticoRESUMO
INTRODUCTION: The tarsal tunnel syndrome is uncommon. It is a neuropathy of the tibial nerve at the level of the tarsal tunnel. The main symptom is pain of the sole of the foot. On percussion Tinel's sign may be found, with sensory loss all over the sole of the foot, or in parts of it, together with weakness of the intrinsic muscles of the foot. In all three cases nerve conduction studies were done and needle electromyography was also done in two cases, confirming the clinical diagnosis. CLINICAL CASES: The three patients were treated conservatively (rest, vitamin B complex and antiinflammatory analgesics). Two patients improved but one required surgical treatment when medical treatment alone was found not to be satisfactory. At the present time, all three patients are asymptomatic. CONCLUSIONS: The tarsal tunnel syndrome is uncommon but not unimportant. In most patients it presents as a syndrome of intense pain of the sole of the foot, with typical clinical features, usually unilateral. Nerve conduction studies and needle electromyography are particularly useful for confirmation of the diagnosis by localization of the problem. Initially conservative treatment is indicated in all cases. Those which do not respond to this will require surgical intervention.
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Síndrome do Túnel do Tarso/diagnóstico , Adulto , Terapia Combinada , Eletromiografia/métodos , Feminino , Humanos , Masculino , Condução Nervosa/fisiologia , Síndrome do Túnel do Tarso/terapia , Nervo Tibial/fisiopatologia , Resultado do TratamentoRESUMO
Introducción. El síndrome del túnel tarsiano es un síndrome poco común. Se trata de una neuropatía del nervio tibial a nivel del túnel tarsiano, cuyo síntoma fundamental es el dolor en la planta del pie. En la exploración puede encontrarse el signo de Tinel, pérdida sensitiva en toda la planta del pie o en áreas de la misma, y debilidad de los músculos intrínsecos del pie. Casos clínicos. Se presentan los casos de tres pacientes con síndrome del túnel tarsiano unilateral. Todos tenían dolor y alteraciones sensitivas en la planta del pie y signo de Tinel positivo; dos presentaban paresia muscular de músculos intrínsecos del pie. En los tres casos se realizaron estudios de conducción nerviosa y electromiografía de agujas en dos de ellos, comprobándose el diagnóstico clínico. Los tres pacientes se sometieron a tratamiento conservador (reposo, vitaminas del complejo B, analgésicos antinflamatorios): dos respondieron favorablemente y uno tuvo que ser intervenido quirúrgicamente por mala respuesta al mismo. Los tres pacientes se encuentran asintomáticos en la actualidad. Conclusiones. El síndrome del túnel tarsiano es una neuropatía infrecuente, pero no por ello menos importante que otras. Se presenta en la mayoría de los pacientes como un síndrome doloroso plantar intenso, con manifestaciones clínicas típicas, más comúnmente unilaterales. Los estudios de conducción nerviosa yla electromiografía de agujas son especialmente útiles en la confirmación del diagnóstico, dado su valor localizador. El tratamiento conservador debe indicarse inicialmente a todos los pacientes, y los que no respondan favorablemente al mismo deben ser intervenidos quirúrgicamente(AU)
