Assuntos
Fadiga/epidemiologia , Esclerose Múltipla/epidemiologia , Adulto , Idoso , Área Programática de Saúde , Fadiga/diagnóstico , Fadiga/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Esclerose Múltipla/complicações , Estudos Retrospectivos , Índice de Gravidade de Doença , Espanha/epidemiologiaRESUMO
A number of drugs have been reported to cause neuromuscular blockade and/or to increase weakness in myasthenia gravis. We report on two patients, treated with felodipine and nifedipine for arterial hypertension, who presented with an exacerbation of their myasthenia gravis and a myasthenic syndrome or exacerbation of myasthenia gravis, respectively. The mechanism of action of calcium antagonist drugs at the neuromuscular junction is not yet well established, but it could be located at both presynaptic and postsynaptic levels.
Assuntos
Bloqueadores dos Canais de Cálcio/efeitos adversos , Felodipino/efeitos adversos , Miastenia Gravis/etiologia , Junção Neuromuscular/efeitos dos fármacos , Nifedipino/efeitos adversos , Idoso , Anti-Hipertensivos/efeitos adversos , Anti-Hipertensivos/uso terapêutico , Felodipino/uso terapêutico , Feminino , Humanos , Masculino , Nifedipino/uso terapêuticoRESUMO
Spinal epidural abscesses account for 1 or 2 of every 10,000 hospital admissions, Staphylococcus aureus being the bacterium most frequently involved. Brucellosis is a disorder of worldwide distribution, relatively frequent in South America and in Mediterranean countries in Europe and Africa. Whilst in the USA only 200 cases are reported every year, in Spain it is the most frequent zoonosis. This systemic disease seldom produces spondylodiscitis which in a minority of cases may be complicated by spinal epidural abscesses, in general of lumbar location. The purpose of this article is to analyse 4 cases of brucellar spinal epidural abscess of cervical location and diagnosed in the Province of Teruel, Spain, an endemic area for the disease, through 10 consecutive years (1990-1999). We consider noteworthy the following facts: the first case was a technical employee who acquired the infection in our laboratory of microbiology, the second presented with an extensive purulent collection invading prevertebral and retropharyngeal regions, the third case was cured only with antibiotics without residual deficits. In the fourth case we were not able to demonstrate spondylodiscitis accompanying the epidural abscess at the C2-C6 levels. We discuss especially the epidemiological aspects of brucellosis, the existence of epidural abscess without spondylodiscitis, the clinical manifestations, the diagnosis by means of magnetic resonance imaging, specific serological tests for Brucella, antibiotic treatment and the prognosis of our cases.