Subject(s)
Humans , Spinal Cord Diseases , Tuberculosis , Myelitis/diagnostic imaging , Spinal Cord , Magnetic Resonance ImagingABSTRACT
Desde la eliminación de la circulación del virus polio salvaje, disminuyeron los casos de parálisis fláccida aguda. Sin embargo, continúan ocurriendo casos asociados a otros enterovirus no polio y virus neurotropos. Se presenta el caso de una paciente de 9 años con diagnóstico de meningitis y mielitis con compromiso motor en los miembros inferiores y vejiga neurogénica asociado a enterovirus, con resolución completa del cuadro neurológico posterior a la administración de gammaglobulina hiperinmune.
Since the wild poliovirus no longer circulates, the number of cases of acute flaccid paralysis decreased. However, cases related to non-polio enteroviruses and neurotrope viruses continue to occur. We present a nine-year-old patient with meningitis and myelitis with motor involvement in the lower limbs and neurogenic bladder associated with enterovirus, with complete resolution of the neurological symptoms following the administration of hyperimmune gammaglobulin.
Subject(s)
Humans , Female , Child , gamma-Globulins/therapeutic use , Enterovirus , Myelitis/diagnostic imaging , ParalysisABSTRACT
ABSTRACT Systemic lupus erythematosus (SLE) is a chronic autoimmune disease involving multiple organs, characterized by the production of autoantibodies and the development of tissue injury. The etiology of SLE is partially known, involving multiple genetic and environmental factors. As many as 50% of patients with SLE have neurological involvement during the course of their disease. Neurological manifestations are associated with impaired quality of life, and high morbidity and mortality rates. Nineteen neuropsychiatric syndromes have been identified associated with SLE, and can be divided into central and peripheral manifestations. This article reviews major neuropsychiatric manifestations in patients with SLE and discusses their clinical features, radiological findings and treatment options.
RESUMO Lúpus eritematoso sistêmico (LES) é uma doença autoimune crônica que envolve múltiplos órgãos e sistemas, caracterizada pela produção de auto anticorpos e lesão tecidual. A etiologia do LES é parcialmente conhecida e envolve interação entre fatores genéticos e ambientais. Até 50% dos pacientes com LES apresentam envolvimento neurológico no decorrer da doença. Manifestações neurológicas estão associadas a prejuízo na qualidade de vida e altas taxas de mortalidade e morbidade. Foram identificadas 19 síndromes neuropsiquiátricas em pacientes com LES, divididas entre manifestações do sistema nervoso central e periférico. O objetivo deste artigo é revisar as manifestações neuropsiquiátricas mais importantes. Serão abordadas as características clínicas, os aspectos radiológicos e opções de tratamento dos eventos neuropsiquiátricos.
Subject(s)
Humans , Lupus Vasculitis, Central Nervous System/complications , Seizures/diagnosis , Autoantibodies/metabolism , Syndrome , Magnetic Resonance Imaging , Cerebrovascular Disorders/diagnostic imaging , Lupus Vasculitis, Central Nervous System/immunology , Lupus Vasculitis, Central Nervous System/therapy , Lupus Vasculitis, Central Nervous System/diagnostic imaging , Headache/diagnosis , Myelitis/diagnostic imaging , Neuropsychological TestsABSTRACT
Schistomiasis is a parasitic infestation that affects an estimated 200 to 300 million people worldwide. Spinal involvement is a rare complication of schistosoma mansoni or schistosoma hematobium infestation. The prevalence of spinal cord shistosomiasis in patients with systemic disease ranges from 0.3% to 13% in different published studies. The pathological findings of spinal shistosomiasis include a granulomatous intramedullary mass of the caudal spinal cord, radicular involvement with granulomatous changes surrounding the conus medullaris and cauda equina nerve roots, granulomatous necrosis and haemorrhage and asymptomatic deposition of ova in the spinal cord. Different imaging modalities have been employed for diagnosis of spinal schistosomiasis including conventional water-soluble contrast myelography, computed tomography [CT], CT myelography and magnetic resonance imaging [MRI]. In this study, we report imaging findings in 5 patients with shistosomal myelitis on CT myelography [1 case] and MRI [4 cases]. Three patients were operated upon and two patients had follow-up MRI after 6 months of antiparasitic therapy. We concluded that MRI should be the primary diagnostic modality employed in patients suspected to have shistosomal myelitis on a clinical and laboratory basis