ABSTRACT
Objective To explore the imaging diagnosis of chorea associated with nonketotic hyperglycemia by describing its CT and MR findings and correlating those findings with the clinical manifestations. Methods The imaging findings and clinical data from 6 patients with chorea associated with nonketotic hyperglycemia were retrospectively analyzed. All 6 patients had unenhanced CT scans, 1 also had MR imaging examination. Three of 6 patients had follow-up CT scans and 1 of 3 patients had follow-up MRimaging studies. Results CT studies of all 6 patients showed unilateral or bilateral hyperdense striatum.The putamen was involved in all 6 patients, the caudate nucleus or lateral portion of the globus pallidus were involved in 5 of all 6 patients. All 3 follow-up CT studies depicted a decreased or resolved hyperdensity of the abnormal striatum. T1-weighted MR images in 1 patient showed the hyperintense lesions of bilateral lentiform nuclei, T2-weighted MR images of the patient showed the hypointense lesions of the corresponding lentiform nuclei, and its follow-up MR images depicted invariable signal intensity of T1-weighted and T2-weighted images. In all patients, the chorea resolved within 2 to 6 days after treatment of the hyperglycemia. Conclusion The characteristic imaging findings of chorea associated with nonketotic hyperglycemia can suggest an accurate diagnosis.
ABSTRACT
INTRODUÇÃO: A coréia de Sydenham é a principal causa de coréia adquirida na infância no Brasil. Assim, torna-se relevante saber como os médicos tratam os pacientes coréicos no nosso meio. OBJETIVO: Descrever a prática médica informada em coréia de Sydenham entre pediatras. MÉTODO: Estudo observacional descritivo seccional realizado por entrevistas feitas entre pediatras de emergência e especialistas dos hospitais públicos do Município do Rio de Janeiro. RESULTADOS: 74 por cento dos entrevistados referiu não usar escalas de gravidade; somente 81 por cento dos médicos fazem uso regular de penicilina benzatina; 64 por cento referem iniciar tratamento farmacológico; 28,3 por cento usam apenas o haloperidol para o tratamento. CONCLUSÃO: As escalas de gravidade não são usadas rotineiramente no atendimento de pacientes coréicos; há tendência à prescrição irregular de penicilina entre médicos mais jovens; o haloperidol é a droga mais prescrita entre os entrevistados.
BACKGROUND: Sydenham's chorea is the most common cause of acquired childhood chorea in Brazil. Thus it is relevant to know how physicians treat those patients. OBJECTIVE: To describe the practice patterns of Sydenham's chorea among pediatricians. METHOD: A descriptive study was undertaken using a questionnaire among specialists and emergency pediatricians who work in public hospitals of Rio de Janeiro district. RESULTS:74 percent of the physicians informed not to use any severity scale; 81 percent informed to always prescribe benzatine penicillin; 64 percent informed to begin pharmacological treatment for all patients; and Haloperidol was the most remembered drug among all physicians. CONCLUSION: Physicians do not use routinely severity scales in follow-up of choreic patients; there is a tendency of irregular prescription of benzatine penicillin by younger doctors; and 28.3 percent prescribe only haloperidol.