RESUMO
BACKGROUND: The aim of this study was to further characterize the clinical phenotype of hepatitis E virus (HEV)-associated neuralgic amyotrophy (NA). METHODS: Three patients with HEV-associated NA underwent clinical, electrodiagnostic, and ultrasound assessment. RESULTS: In all patients, symptoms developed in several phases within a time span of 4-6 weeks, with three or more nerves involved. Symptoms were bilateral in two. In two patients, nerves of the trunk and the lower limb were affected as well. In one patient, three bouts occurred, each heralded by an increase in pain. In the other two, pain subsided quickly and nerve damage developed in two phases. Segmental enlargement with or without hourglass-like constrictions of the nerves was demonstrated by ultrasound in all. CONCLUSIONS: The multiphasic presentation, together with the extensive multi-nerve involvement, may reflect a severe and protracted inflammation of the nerves in HEV-associated NA.
Assuntos
Neurite do Plexo Braquial/diagnóstico , Neurite do Plexo Braquial/etiologia , Hepatite E/complicações , Adulto , Plexo Braquial/diagnóstico por imagem , Neurite do Plexo Braquial/diagnóstico por imagem , Eletrodiagnóstico , Eletromiografia , Hepatite E/diagnóstico por imagem , Humanos , Masculino , Nervo Mediano/diagnóstico por imagem , Músculo Esquelético/diagnóstico por imagem , Fenótipo , Nervos Espinhais/diagnóstico por imagem , Nervos Torácicos/diagnóstico por imagem , UltrassonografiaAssuntos
Doenças dos Gânglios da Base/diagnóstico , Neoplasias Encefálicas/diagnóstico , Córtex Cerebral/patologia , Hemangioma Cavernoso do Sistema Nervoso Central/diagnóstico , Siderose/diagnóstico , Tálamo/patologia , Doenças dos Gânglios da Base/etiologia , Neoplasias Encefálicas/complicações , Feminino , Hemangioma Cavernoso do Sistema Nervoso Central/complicações , Humanos , Pessoa de Meia-Idade , Siderose/etiologia , SíndromeRESUMO
We report the association of ipsilateral trigemino-autonomic headache to a case of right-sided nuclear facial and abducens palsy (Gasperini syndrome), ipsilateral hypacusis and right hemiataxia, caused by the occlusion of the right anterior inferior cerebellar artery. Short-lasting attacks of mild to moderate ipsilateral fronto-periorbital head pain, accompanied by lacrimation and mild conjunctival injection during more severe attacks, were present from the onset of symptoms, with a gradual worsening over the next few months and remitting during naproxen therapy. Magnetic resonance imaging showed an infarct in the right cerebellar peduncle, extending toward the pontine tegmentum, also involving the ipsilateral spinal trigeminal nucleus and tract and the trigeminal entry zone. Gasperini syndrome may be accompanied by ipsilateral trigemino-autonomic head pain.
