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1.
Biomédica (Bogotá) ; 41(4): 625-630, oct.-dic. 2021. graf
Article in Spanish | LILACS | ID: biblio-1355737

ABSTRACT

Resumen | Como los otros herpesvirus alfa, el virus de la varicela-zóster (VZV) permanece en estado de latencia en los ganglios neurales después de la infección primaria (varicela). La reactivación de una infección latente por VZV en los ganglios de la raíz dorsal, produce el herpes zóster. La erupción que este provoca se caracteriza por lesiones cutáneas metaméricas que se acompañan de dolor neurítico y comprometen con mayor frecuencia a ancianos y sujetos inmunocomprometidos, en especial, aquellos infectados con el virus de la inmunodeficiencia humana (HIV). Las complicaciones que se observan en esta población de pacientes incluyen neumonía, hepatitis y compromiso del sistema nervioso central (meningitis y encefalitis). Varios síndromes clínicos se asocian con el herpes zóster de localización craneal, incluida la parálisis facial periférica y el síndrome de Ramsay-Hunt, el cual constituye la segunda causa de parálisis facial periférica y tiene una gran variedad de presentaciones clínicas. La parálisis facial se presenta en 60 a 90 % de los casos de síndrome de Ramsay-Hunt, puede preceder o aparecer después de las lesiones cutáneas y tiene peor pronóstico que la parálisis de Bell. Se describen aquí dos casos de herpes zóster del ganglio geniculado, con parálisis facial periférica que coincidió con la aparición de las lesiones cutáneas vesiculosas en el conducto auditivo externo y el pabellón auricular (síndrome de Ramsay-Hunt multimetamérico). En ambos casos, se identificó el genoma del VZV mediante PCR en el líquido cefalorraquídeo (LCR).


Abstract | Like other alpha-herpesviruses, the varicella-zoster virus (VZV) remains latent in the neural ganglia following the primary varicella infection. The reactivation of the VZV in the dorsal root ganglia results in herpes zoster. Herpes zoster eruption is characterized by localized cutaneous lesions and neuralgic pain mostly in older and immunocompromised persons, especially those living with the human immunodeficiency virus (HIV). The most commonly reported complications include VZV pneumonia, meningitis, encephalitis, and hepatitis. Several neurologic syndromes have been described associated with herpes zoster localized in cranial areas including peripheral nerve palsies and the Ramsay-Hunt syndrome, which has a varied clinical presentation and is the second most common cause of peripheral facial paralysis. Facial paralysis in this syndrome occurs in 60 to 90% of cases and it may precede or appear after the cutaneous lesions with a worse prognosis than idiopathic Bell paralysis. Here we present two cases of herpes zoster from the geniculate ganglia with peripheral facial paralysis that appeared simultaneously with vesicular herpetic otic lesions (multimetameric Ramsay-Hunt syndrome). In the two cases, amplifiable varicella-zoster viral DNA was found in the cerebrospinal fluid by RT-PCR Multiplex.


Subject(s)
Facial Paralysis , Herpes Zoster , Cerebrospinal Fluid , Acquired Immunodeficiency Syndrome , HIV
2.
Arch. argent. pediatr ; 119(1): e58-e60, feb. 2021.
Article in Spanish | LILACS, BINACIS | ID: biblio-1147267

ABSTRACT

El virus SARS-CoV-2, responsable de la pandemia de COVID-19, es un agente infeccioso emergente. El conocimiento tanto de sus mecanismos de infectividad como de las posibles complicaciones y tratamientos específicos es motivo de constante investigación.Para comprender la afectación del sistema nervioso central en los niños, se estudia el comportamiento de este germen basándose en las propiedades neuroinvasivas de ciertos virus respiratorios, el daño neurológico causado por otros coronavirus y las manifestaciones clínicas en adultos con COVID-19.Se describe el caso clínico de un paciente de 2 meses de edad que consultó por un cuadro febril sin foco con detección de SARS-CoV-2 por reacción en cadena de la polimerasa con transcriptasa inversa en secreciones nasofaríngeas y el líquido cefalorraquídeo. Presentó buena evolución, con resolución de la fiebre y sin compromiso ni manifestaciones neurológica


The SARS-CoV-2 virus, responsible for the COVID-19 pandemic, is an emerging infectious agent. The knowledge of both its infectivity mechanisms and the possible complications and specific treatments is the subject of constant research. To understand the involvement of the central nervous system in children, the behavior of this germ is studied based on the neuroinvasive properties of certain respiratory viruses, the neurological damage caused by other coronaviruses, and the clinical manifestations in adults with COVID-19.We describe the clinical case of a 2-month-old patient who consulted for fever without a focus with detection of SARS-CoV-2 by reverse transcription polymerase chain reaction in nasopharyngeal secretions and cerebrospinal fluid. The infant presented good evolution, with resolution of the fever and without compromise or neurological manifestation


Subject(s)
Humans , Male , Infant , Coronavirus , Pediatrics , Cerebrospinal Fluid , Polymerase Chain Reaction
3.
Rev. cuba. invest. bioméd ; 40(supl.1): e1584, 2021. tab, graf
Article in English | LILACS, CUMED | ID: biblio-1289475

ABSTRACT

Introduction: MASP-2 is a mannose blinding lectin associate to serine protease in cerebrospinal fluid and its dynamics through the blood brain barrier is unknown. Objective: To describe MASP-2 diffusion pattern from blood to cerebrospinal fluid. Methods: A transversal observational prospective study was performed 56 control samples of cerebrospinal fluid and serum were employed. ELISA measured MASP-2. Two groups were made: control patients without organic brain disease with normal cerebrospinal fluid and normal barrier function and patients without inflammatory diseases with a blood cerebrospinal fluid barrier dysfunction. Results: MASP-2 concentration in cerebrospinal fluid increase with augment the Q Albumin. QMASP-2 vs. Q Albumin saturation curve indicates that MASP-2 is interacting with other molecules in the subarachnoid environment. The higher inter-individual variation of cerebrospinal fluid MASP-2 of the control compared to the serum MASP-2 indicates that MASP-2 is a protein derived from blood. Conclusions: MASP-2 in CSF is predominantly blood-derived. The saturation curve demonstrates that MASP-2 interacts with the starters of the lectin pathway like mannose binding lectin, ficolins and collectin LK(AU)


Introducción: MASP2 es una proteína de unión a manosa asociada a una proteasa de serina encontrada en la periferia, pero puede pasar a líquido cefalorraquídeo. Sin embargo, su dinámica a través de la barrera sangre-líquido cefalorraquídeo es aún desconocida. Objetivo: Describir la difusión del MASP-2 desde la sangre al líquido cefalorraquídeo. Métodos: Se realiza estudio observacional prospectivo de corte transversal donde se emplearon 56 muestras de suero y líquido cefalorraquídeo. Fue seleccionado un grupo control con pacientes sin enfermedad orgánica del cerebro, con líquido cefalorraquídeo y función de barrera normal y otro grupo de pacientes sin enfermedades inflamatorias del cerebro con disfunción de barrera sangre-líquido cefalorraquídeo. Resultados: La concentración de MASP-2 en líquido cefalorraquídeo aumentó con el incremento de la Q Albúmina. La curva de saturación de Q MASP-2 contra la Q Albúmina indicó que el MASP-2 se encuentra interactuando con otras moléculas en el espacio subaracnoideo. El aumento del coeficiente de variación individual de MASP-2 en líquido cefalorraquídeo de los controles comparado con el MASP-2 en suero indicó que el MASP-2 es una proteína derivada de la sangre. Conclusiones: La producción de MASP-2 en líquido cefalorraquídeo es predominantemente derivada de la sangre. La curva de saturación demostró que el MASP-2 interactúa con los iniciadores de la vía de las lectinas como lectina unida a manosa, las ficolinas y la colectina LK(AU)


Subject(s)
Humans , Enzyme-Linked Immunosorbent Assay , Blood-Brain Barrier , Cerebrospinal Fluid/physiology , Mannose-Binding Protein-Associated Serine Proteases , Mannose , Cross-Sectional Studies , Prospective Studies
4.
Pesqui. vet. bras ; 41: e06912, 2021. tab, graf, ilus
Article in English | LILACS, VETINDEX | ID: biblio-1346689

ABSTRACT

Equine leukoencephalomalacia (LEM) is a disease caused by the ingestion of food, especially corn, contaminated by fumonisin, a Fusarium verticillioides (synonymous with F. moniliforme) metabolite. The clinical signs of brain injuries have an acute onset and rapid evolution. This study aimed to describe the clinical findings in 11 animals diagnosed with LEM, including cerebrospinal fluid (CSF) analysis. Of these animals, 91% (10/11) were horses, and only 9% (1/11) were asinine. The clinical localization of the lesions was 64% (7/10) cerebral, manifested mainly by altered mental state and behavioral disturbance, and 36% (4/11) were brainstem lesions, manifested by incoordination, head tilt, nystagmus, facial hypoalgesia, difficulty in apprehension, chewing, and swallowing food. Postmortem findings revealed that 82% (9/11) of the lesions were in the cerebrum and 18% (2/11) in the brainstem. CSF findings, such as xanthochromia (43%, 3/7), hyperproteinorrachia (50%, 3/6), and pleocytosis (43%, 3/7) were observed. The affected animals showed neurological signs that were compatible with cerebral and/or brainstem injuries. The CSF from animals with LEM may present with xanthochromia, hyperproteinorrachia, and pleocytosis, reinforcing the fact that this disease should be included in the differential diagnosis of encephalomyelopathies.(AU)


A leucoencefalomalácia (LEM) é uma enfermidade que acomete equídeos causada pela ingestão de milho e seus derivados e feno contaminados pela micotoxina fumonisina, um metabólito do fungo Fusarium verticillioides (sinônimo para F. moniliforme). Os sinais clínicos apresentam início agudo e evolução rápida e são decorrentes de lesões encefálicas. O objetivo deste estudo é descrever os achados clínicos de 11 equídeos diagnosticados com LEM, incluindo a análise do líquido cefalorraquidiano (LCR). 91% dos animais afetados eram equinos e somente 9% (1/11) era asinino. A localização clínica das lesões era 64% (7/10) cerebrais, manifestadas por alterações no estado mental e comportamento e 36% (4/10) no tronco encefálico, manifestadas por incoordenação, desvio lateral de cabeça, nistagmo, hipoalgesia da face e dificuldade de apreensão, mastigação e deglutição de alimentos. Comparativamente, os achados post mortem revelaram que 82% (9/11) das lesões eram no cérebro e 18% (2/11) no tronco encefálico. Alterações no LCR, tais como xantocromia (43%, 3/7), hiperproteinorraquia (50%, 3/6) e pleocitose (43%, 3/7), foram observadas. Os animais afetados apresentaram sinais clínicos compatíveis com lesões encefálicas e/ou de tronco cerebral. O LCR de animais com LEM pode apresentar xantocromia, hiperproteinorraquia, e pleocitose, reforçando que esta doença deve ser incluída como diagnóstico diferencial de encefalomielites.(AU)


Subject(s)
Animals , Brain Injuries , Cerebrospinal Fluid , Leukoencephalopathies/microbiology , Fusarium , Horses , Leukocytosis , Mycotoxins , Eating
5.
Gac. méd. boliv ; 43(2): 184-189, dic. 2020. ilus
Article in Spanish | LILACS | ID: biblio-1249982

ABSTRACT

La ecografía es una herramienta de gran ayuda en medicina, rápido, tecnología portátil y segura. Así por ejemplo realización de la punción lumbar (accesos vasculares y bloqueos regionales) para la obtención de líquido cefalorraquídeo por médicos de emergencia y anestesiólogos, etc. Como ventajas tenemos: disminución del número de punciones lumbares, satisfacción del paciente. Es una alternativa en pacientes con alta probabilidad de punción lumbar difícil como por ejemplo: pacientes obesos, pacientes con edema, con antecedentes de cirugía columna previa, escoliosis. En el presente artículo tiene como objetivo brindar información sobre la utilidad de la ecografía en la punción lumbar en adultos y la obtención del líquido cefalorraquídeo. Proponer una abordaje metódico para puncion lumbar y el bloqueo neuroaxial en tiempo estático por ecografía de la columna lumbar del adulto. Se realizó la búsqueda de la bibliografía de revistas académicas de medicina y anestesiología disponibles en base de datos confiables.


Ultrasound is a tool of great help in medicine, fast, portable and safe technology. Thus, for example, the performance of lumbar punctures (vascular accesses and regional blocks) to obtain cerebrospinal fluid by emergency physicians and anesthesiologists, etc. As advantages we have: decrease in the number of lumbar punctures, patient satisfaction. It is an alternative in patients with a high probability of difficult lumbar puncture such as: obese patients, patients with edema, with a history of previous spinal surgery, scoliosis. The aim of this article is to provide information on the usefulness of ultrasound in lumbar puncture in adults and obtaining cerebrospinal fluid. To propose a methodical approach for lumbar puncture and neuraxial block in static time by ultrasound of the lumbar spine in adults. A search was made of the bibliography of academic journals of medicine and anesthesiology available in reliable databases.


Subject(s)
Spinal Puncture , Ultrasonography , Scoliosis , Spine , Cerebrospinal Fluid , Anesthesiologists
6.
An. Fac. Cienc. Méd. (Asunción) ; 53(3): 173-176, 20201201.
Article in Spanish | LILACS | ID: biblio-1178015

ABSTRACT

Introducción: Los Quistes Aracnoideos son colecciones benignas de líquido cefalorraquídeo que representan el 1% de lesiones ocupantes de espacios intracraneales. Se detecta frecuentemente antes de los 20 años, entre 60 a 90% de los casos. La prevalencia estimada es de 1,4% en adultos, siendo la menos frecuente la ubicación intraventricular. Caso Clínico: Mujer de 60 años de edad, consultó por cefalea holocraneana de larga data y ocasionales mareos. Sin alteraciones al examen físico neurológico. Se le realizó tomografía axial computarizada donde llamó la atención una leve alteración de la densidad intraventricular por lo que se procedió a realizar resonancia magnética nuclear que demostró imágenes quísticas en atrio de ventrículos laterales, bilateral. No se requirió de una intervención quirúrgica debido a que la paciente no presentaba sintomatología significativa. Discusión: El tratamiento quirúrgico es recomendado en pacientes sintomáticos, en quistes de gran extensión y en los que cursan con complicaciones. Para los pacientes que cursen sólo con dolor de cabeza, sin hidrocefalia secundaria o un aumento evidente de la presión intracraneal se recomienda la observación con o sin repetición de las imágenes.


Introduction: Arachnoid cysts are benign collections of cerebrospinal fluid that represents 1% of lesions occupying intracranial spaces. It is frequently detected before the age of 20, between 60 to 90% of cases. The estimated prevalence is 1.4% in adults, the least frequent being intraventricular location. Clinical Case: A 60-year-old woman attended for a long-standing holocranial headache and occasional dizziness. No alteration in the neurological physical examination. A computerized axial tomography was performed, where a slight alteration in the intraventricular density drew attention, for which a nuclear magnetic resonance was carried out, which showed cystic images in the atrium of bilateral lateral ventricles. No surgical intervention was required because the patient did not present a significant symptomatology. Discussion: Surgical treatment is recommended in symptomatic patients, in cysts of great extension and in those with complications. For patients with only headache, without secondary hydrocephalus or an obvious increase in intracranial pressure, observation with or without repetition of the images is recommended.


Subject(s)
Magnetic Resonance Spectroscopy , Tomography , Headache , Hydrocephalus , Women , Intracranial Pressure , Cerebrospinal Fluid , Observation
7.
Rev. méd. Urug ; 36(4): 156-184, dic. 2020. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1144756

ABSTRACT

Resumen: El drenaje lumbar externo es un procedimiento invasivo de extracción de líquido cefalorraquídeo del espacio espinal cuyo uso se ha incrementado en los últimos años en el contexto de la medicina neurocrítica. Si bien no es recomendado por las guías o consensos internacionales, tiene un lugar en el manejo de algunas situaciones clínicas específicas vinculadas a diferentes tipos de neuroinjuria grave. Se realiza una revisión no sistemática de la literatura, a lo que se suma la experiencia de los autores. Se plantean las principales indicaciones actuales, se detallan las características de su manejo en los distintos escenarios clínicos y se señalan las contraindicaciones y complicaciones del procedimiento.


Summary: The placement of an external lumbar drainage (ELD), an invasive procedure to extract cerebrospinal fluid (CSF) from the spinal space, has gradually increased in practice in recent years within the context of neurocritical medicine. Despite it not being recommended by international guidelines or consensus, it is used for the handling of a few specific clinical situations in connection with different types of severe brain injury. The study consists of a non-systematic review of the literature, along with the authors' experience, presenting the main current indications and details for its handling in the different clinical scenarios and describing side effects and complications of the procedure.


Resumo: A drenagem lombar externa é um procedimento invasivo para extração do líquido cefalorraquidiano do espaço espinhal, cujo uso tem aumentado nos últimos anos no contexto da medicina neurocrítica. Embora não seja recomendado por consensos ou diretrizes internacionais, tem lugar no manejo de algumas situações clínicas específicas ligadas a diferentes tipos de dano neurológico grave. Realiza-se uma revisão não sistemática da literatura, à qual se soma a experiência dos autores. Apresentam-se as principais indicações atuais, detalham-se as características de seu manejo nos diferentes cenários clínicos e apontam-se as contraindicações e complicações do procedimento.


Subject(s)
Subarachnoid Hemorrhage , Cerebrospinal Fluid , Drainage , Intracranial Hypertension
8.
Int. j. morphol ; 38(5): 1421-1425, oct. 2020. tab
Article in Spanish | LILACS | ID: biblio-1134458

ABSTRACT

RESUMEN: En el campo morfológico internacional se utiliza el término líquido cerebroespinal, identificado en latín como Liquor cerebrospinalis. En el humano, este líquido circula por varias cavidades del sistema nervioso central, de las cuales, se reconocen cinco ventrículos. Cuatro son componentes encefálicos y uno se encuentra en la parte terminal de la médula espinal. El objetivo del presente trabajo fue determinar cuál es el nombre más apropiado para este líquido, valorando el uso corriente que se da en libros de texto usados para la enseñanza de la neuroanatomía y en artículos científicos. Para ello, se efectuó una búsqueda bibliografía, no sistemática y aleatoria, de libros y artículos científicos en los cuales se hace mención sobre el fluido del sistema ventricular encefálico y el espacio subaracnoideo del ser humano. El 100 % de los libros y artículos científicos publicados en inglés, utilizaron el término líquido cerebroespinal para denominar este fluido. El 90 % de los libros y artículos científicos publicados en español utilizaron el término líquido cefalorraquídeo y el 10 % de ellos, líquido cerebroespinal. Los resultados demuestran que en América Latina aún se utiliza más de un nombre para una misma estructura. Tanto libros como artículos científicos publicados en español no han seguido las recomendaciones de la Federación Internacional de Asociaciones de Anatomistas (IFAA), ya que la mayoría de ellos utilizó el término líquido cefalorraquídeo. Por otra parte, creemos que el término más apropiado para referirse al líquido extracelular que circula por el sistema ventricular nervioso y espacio subaracnoideo, es el de líquido encéfaloespinal. Este término se propone para suplir el vigente y tradicional líquido cerebroespinal en inglés y líquido encefalorraquídeo en español.


SUMMARY: The term cerebrospinal fluid is generally used in morphology. In Latin it is known as liquor cerebrospinalis. In the human, this fluid circulates through various cavities of the central nervous system, of which, five ventricles are recognized. Four are brain components and one is in the terminal part of the spinal cord. The objective of the present study was to determine the most appropriate term for this liquid, while evaluating the current use of terminology in scientific publications and in academic textbooks used to tech neuroanatomy. A non-systematic and randomized bibliographic search of books and scientific articles was carried out, making mention of the encephalic ventricular system fluid and the subarachnoid space of the humans. A total, (100 %) of identified scientific books and articles published in English, used the term cerebrospinal fluid to refer to this fluid; 90 % of the scientific books and articles published in Spanish used the term cephalic-rachid fluid; cerebrospinal fluid was used in 10 % of these. The results show that more than one term continues to be used in Latin America to refer to this structure. International Federation of Anatomical Associations (IFAA) recommendations have not been followed, since most books and scientific research publications use the term cerebrospinal fluid to describe the structure. Moreover, we believe that the cephalic-spinal fluid is the most appropriate term in this case, given that circulation occurs throughout the ventricular nervous system and the subarachnoid space. This term is proposed to replace the current and traditional cerebrospinal fluid in English and cephalic-rachid fluid in Spanish.


Subject(s)
Humans , Cerebrospinal Fluid , Neuroanatomy , Terminology as Topic
9.
Rev. cuba. med ; 59(3): e1342, tab
Article in Spanish | LILACS, CUMED | ID: biblio-1139055

ABSTRACT

Introducción: Las infecciones del sistema nervioso central constituyen un problema de salud a nivel mundial por la elevada morbimortalidad que produce. Objetivo: Caracterizar clínicamente a pacientes con infección del sistema nervioso central. Métodos: Estudio observacional, descriptivo y retrospectivo (2009-2018) en pacientes con infección del sistema nervioso central atendidos en el Hospital Hermanos Ameijeiras. Las variables estudiadas fueron: edad, sexo, tipo de infección, estado de inmunocompetencia, manifestaciones clínicas, complicaciones, agentes etiológicos, celularidad en el líquido cefalorraquídeo, estado al egreso, estadía hospitalaria. Resultados: Fueron incluidos 133 pacientes, 52,6 por ciento eran del sexo masculino y 45,9 por ciento tenían entre 40-59 años. Prevalecieron los pacientes con infecciones bacteriana en 58,6 por ciento, el staphylococcus sp fue el agente etiológico que más se identificó, la meningoencefalitis representó 36,8 por ciento, estaban inmunodeprimidos 56,4 por ciento, la cefalea y la fiebre estuvieron presente en 82,7 por ciento y la rigidez nucal en 15 por ciento. Las complicaciones respiratorias y la hidrocefalia representaron 21 por ciento y 12,8 por ciento respectivamente. El estado al egreso se asoció al estado de inmunocompetencia (p=0,002), la estadía hospitalaria (p=0,001) y el tipo de infección (p=0,002). Conclusiones: El principal tipo de infección según predominio de la celularidad fue la bacteriana, fue bajo el número de agentes etiológicos identificados. La meningoencefalitis fue la infección más frecuente. La cefalea, la fiebre y la rigidez nucal los síntomas y signos que predominaron, así como las complicaciones respiratorias y la hidrocefalia. Hubo asociación del estado al egreso con el tipo de infección, estado de inmunocompetencia y la estadía hospitalaria(AU)


Introduction: Central nervous system infections constitute a health problem worldwide due to the high morbidity and mortality that it produces. Objective: To clinically describe patients with central nervous system infection. Methods: An observational, descriptive and retrospective study was carried out from 2009 to 2018, in patients with central nervous system infection treated at Hermanos Ameijeiras Hospital. The variables studied were age, sex, type of infection, immunocompetence status, clinical manifestations, complications, etiological agents, cellularity in the cerebrospinal fluid, state at discharge, hospital stay. Results: One hundred thirty three patients were included, 52.6 percent were male and 45.9 percent aged between 40-59 years. Patients with bacterial infections prevailed in 58.6 percent, staphylococcus sp was the most identified etiological agent, meningoencephalitis accounted 36.8 percent, 56.4 percent were immunosuppressed, headache and fever were present in 82.7 percent and nuchal rigidity in 15 percent. Respiratory complications and hydrocephalus covered 21 percent and 12.8 percent respectively. Status at discharge was associated with immunocompetence status (p = 0.002), hospital stay (p = 0.001) and type of infection (p = 0.002). Conclusions: Bacterial infection was the main type of infection according to the cellularity predominance; the number of etiological agents identified was low. Meningoencephalitis was the most frequent infection. Headache, fever and nuchal stiffness were the predominant symptoms and signs, as well as respiratory complications and hydrocephalus. There was an association of the state at discharge with the type of infection, immunocompetence status and hospital stay(AU)


Subject(s)
Central Nervous System Infections/diagnosis , Central Nervous System Infections/epidemiology , Cerebrospinal Fluid/diagnostic imaging , Retrospective Studies , Observational Study
10.
Pesqui. vet. bras ; 40(5): 346-354, May 2020. tab
Article in English | LILACS, VETINDEX | ID: biblio-1135630

ABSTRACT

Ruminants may be affected by a wide variety of central nervous system (CNS) diseases. Cerebrospinal fluid (CSF) analysis forms the basis for ante mortem diagnostic evaluation of ruminants with clinical signs involving the CNS. Despite its importance as a tool to aid diagnosis, data regarding CSF examinations in spontaneous cases of CNS diseases in ruminants from Brazil are limited, and most reports involve experimental studies. Therefore, this study aimed to report the results of CSF analysis in 58 ruminants showing signs of neurological disorders. CSF samples for analysis were obtained from 32 cattle, 20 sheep, and 6 goats by cerebello-medullary cistern (n=54) or lumbosacral space (n=4) puncture. These ruminants showed neurological signs related to viral (n=13), mycotic (n=3), or bacterial (n=15) infections, and toxic (n=21), traumatic (n=4), or congenital disorders (n=2). CSF analysis from ruminants with viral infections presented lymphocytic pleocytosis, even though CSF showed no changes in several cases of rabies. Neutrophilic pleocytosis, cloudiness, presence of fibrin clots, and abnormal coloration were evident in the CSF of most cases of CNS bacterial infection, such as meningoencephalitis, meningitis, abscesses, myelitis, and a case of conidiobolomycosis. On the other hand, CSF was unchanged in most cases of toxic disorders, as botulism and hepatic encephalopathy. Elevated CSF density was observed in 60% of ruminants diagnosed with polioencephalomalacia. Our findings show that evaluation of CSF is a valuable diagnostic tool when used in association with epidemiological, clinical and pathological findings for diagnosis of CNS diseases in ruminants.(AU)


Os ruminantes podem ser afetados por uma grande variedade de doenças do sistema nervoso central (SNC). A análise do líquido cefalorraquidiano (LCR) constitui a base da avaliação diagnóstica ante mortem de ruminantes com sinais clínicos envolvendo o SNC. Apesar de sua importância como ferramenta para auxiliar no diagnóstico, os dados referentes aos exames do LCR em casos espontâneos de doenças do SNC em ruminantes no Brasil são limitados, e, a maioria dos relatos envolve estudos experimentais. Portanto, este trabalho teve como objetivo relatar os resultados da análise do LCR em 58 ruminantes com distúrbios neurológicos. Amostras do LCR foram obtidas de 32 bovinos, 20 ovinos e 6 caprinos por punção da cisterna cerebelo-medular (n=54) ou espaço lombossacro (n=4) para posterior análise. Esses ruminantes apresentaram sinais neurológicos relacionados a infecções virais (n=13), micóticas (n=3) ou bacterianas (n=15), e desordens tóxicas (n=21), traumáticas (n=4) ou congênitas (n=2) A análise do LCR de ruminantes com infecções virais apresentou pleocitose linfocítica, embora, em vários casos de raiva, o LCR não tenha apresentado alterações. Pleocitose neutrofílica, turbidez, presença de coágulos de fibrina e coloração anormal foram evidentes no LCR da maioria dos casos de infecções bacterianas do SNC, como meningoencefalites, meningites, abscessos, mielite e um caso de conidiobolomicose. Por outro lado, o LCR não foi alterado na maioria dos casos dos distúrbios tóxicos, como botulismo e encefalopatia hepática. A densidade elevada no LCR foi observada em 60% dos ruminantes diagnosticados com polioencefalomalácia. Nossos resultados mostram que a avaliação do LCR é uma valiosa ferramenta de diagnóstico, quando usada em associação com os achados epidemiológicos, clínicos e patológicos para o diagnóstico de doenças do SNC em ruminantes.(AU)


Subject(s)
Animals , Cattle , Goats/cerebrospinal fluid , Sheep/cerebrospinal fluid , Cerebrospinal Fluid , Nervous System Diseases/diagnosis , Nervous System Diseases/pathology , Spinal Puncture/veterinary , Nervous System Diseases/veterinary
11.
Arq. neuropsiquiatr ; 78(3): 163-168, Mar. 2020. tab
Article in English | LILACS | ID: biblio-1098075

ABSTRACT

Abstract Herpes simplex virus (HSV) is a cause of a severe disease of the central nervous system (CNS) in humans. The demonstration of specific antibodies in the cerebrospinal fluid (CSF) may contribute to the retrospective neurological diagnosis. However, the commercial immunological tests for HSV infection are for use in serum samples. Objective: The aim of the present study was to adapt a commercial kit anti-HSV IgG used for serum samples to be performed with a CSF sample. Methods: Forty CSF specimens from 38 patients with suspected CNS HSV infection were serially diluted for detecting anti-HSV IgG by enzyme immunoassay (EIA). The same samples were also analyzed with the polymerase chain reaction (PCR). Results: The sensitivity of EIA test for HSV was 5% (dilution 1:40) and 65% (dilution 1:2) in CSF, and HSV DNA PCR was 15%. The combined analysis of EIA (dilution 1:2) and PCR increased the sensitivity up to 72.5%. The inflammatory CSF was associated with positive HSV PCR. Conclusions: We demonstrated the importance to adapt serological anti-HSV IgG EIA test for CSF assays to increase the accuracy of the analysis, considering the low concentration of specific antibodies in CSF.


Resumo O vírus herpes simples (HSV) é um dos agentes causadores de uma doença grave no sistema nervoso central (SNC) em humanos. A detecção de anticorpos específicos no líquido cefalorraquidiano (LCR) pode contribuir para o diagnóstico neurológico retrospectivo. Entretanto, os testes imunológicos comerciais são para uso em amostras de soro. Objetivo: Adaptar um kit comercial sorológico anti-HSV IgG para ser utilizado no de LCR. Metodos: Quarenta amostras de LCR de 38 pacientes com suspeita de infecção por HSV no SNC foram diluídas pesquisa de anticorpos anti-HSV IgG pelo método imunoenzimático (EIA). Além disso, as mesmas amostras também foram analisadas por reação em cadeia da polimerase (PCR). Resultados: A sensibilidade do teste EIA para o HSV consistiu em 5% (diluição 1:40) e 65% (diluição 1:2) no LCR, e o PCR do DNA do HSV, 15%. A análise combinada de EIA (diluição 1:2) e PCR aumentou a sensibilidade para 72,5%. Houve associação entre presença do LCR inflamatório e PCR positiva para HSV. Conclusões: Demonstramos a importância na adaptação previa do teste sorológico anti-HSV IgG EIA para ensaios do no LCR, a fim de aumentar a acuracia da análise, considerando a baixa concentração de anticorpos específicos no LCR.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Cerebrospinal Fluid/virology , Simplexvirus/isolation & purification , Herpes Simplex/diagnosis , Herpes Simplex/virology , Antibodies, Viral/cerebrospinal fluid , Viral Proteins , DNA, Viral/genetics , Polymerase Chain Reaction/methods , Retrospective Studies , Simplexvirus/genetics , DNA-Directed DNA Polymerase/genetics , Exodeoxyribonucleases , Herpes Simplex/cerebrospinal fluid , Nervous System
12.
Arq. neuropsiquiatr ; 78(3): 176-178, Mar. 2020. graf
Article in English | LILACS | ID: biblio-1098073

ABSTRACT

Abstract At the beginning of the 20th century, cerebrospinal fluid (CSF) collection and analysis emerged as a promising aid in the diagnosis of diseases of the central nervous system. It was obtained through the established procedure of lumbar puncture, described by Heinrich Quinke in 1891. The search for an alternative way to gather the CSF emerged in animal research, highlighting the cisterna magna as a promising source, with relative safety when performed by someone trained. Described initially and in detail by James Ayer in 1920, the procedure was widely adopted by neurologists and psychiatrists at the time, featuring its multiple advantages and clinical applications. After a period of great procedure use and exponential data collection, its complications and risks relegated the puncture of the cisterna magna as an alternative route that causes fear and fascination in modern Neurology.


Resumo No início do século XX, a coleta e análise do líquido cefalorraquidiano (LCR) despontavam como um promissor auxílio no diagnóstico das doenças do sistema nervoso central. Sua obtenção se dava através do consagrado procedimento de punção lombar, descrito por Heinrich Quinke em 1891. A busca por uma via alternativa na obtenção do LCR ganhou destaque nas pesquisas animais, destacando-se na cisterna magna promissora fonte, com relativa segurança quando executada por alguém treinado. Descrito inicialmente e de maneira pormenorizada por James Ayer em 1920, o procedimento foi amplamente adotado por neurologistas e psiquiatras à época, com destaque para suas múltiplas vantagens e aplicações clínicas. Após um período de grande uso do procedimento e exponencial obtenção de dados, suas complicações e riscos relegaram a punção da cisterna magna como via alternativa que causa medo e fascínio na Neurologia moderna.


Subject(s)
Animals , History, 19th Century , History, 20th Century , Spinal Puncture/history , Cerebrospinal Fluid , Cisterna Magna/surgery , Spinal Puncture/methods , Punctures
13.
Rev. bras. anal. clin ; 52(1): 99-100, 20200330. tab
Article in Portuguese | LILACS | ID: biblio-1116506

ABSTRACT

O novo coronavírus (SARS-Coronavírus-2: SARS-Cov-2) foi inicialmente relatado em 2019, em Wuhan, China, onde o aparecimento de muitos casos inexplicáveis de pneumonia severa deixou em alerta todos os serviços de saúde do mundo. A Organização Mundial da Saúde (OMS) declarou recentemente uma pandemia, com mais de um milhão de casos relatados até o momento de COVID-19. A relação da fisiopatologia deste novo agente infeccioso associado ao comportamento dos achados laboratoriais do exame do líquor-LCR, através das descrições de casos e relatos, é importante para a análise, interpretação e apoio diagnóstico.


The new coronavirus (SARS-Coronavirus-2: SARS-Cov-2), was initially reported in 2019 in Wuhan, China, where the appearance of many unexplained cases of severe pneumonia has put all health services on alert of the world. The World Health Organization (WHO) recently declared a pandemic, with more than 1,000,000 cases reported to date as of COVID-19. The pathophysiological relationship of this new infectious agent associated with the behavior of laboratory findings of Cerebrospinal Fluid (CSF) examination, through case descriptions and reports, are important for analysis, interpretation and diagnostic support.


Subject(s)
Humans , Cerebrospinal Fluid , Cytological Techniques , Coronavirus Infections , Coronavirus , Neurotology
14.
rev. cuid. (Bucaramanga. 2010) ; 11(1): e784, Ene.-2020.
Article in Portuguese | LILACS, BDENF, COLNAL | ID: biblio-1118230

ABSTRACT

Introdução: A hidrocefalia é uma complicação frequente entre os pacientes neurológicos e seu tratamento em casos agudos é por meio de um cateter de derivação ventricular externa que possibilita a monitorização e o controle da hipertensão intracraniana. O objetivo desse estudo foi descrever a retenção do conhecimento dos enfermeiros após intervenção educativa sobre cuidados com derivação ventricular externa. Materiais e Métodos: Estudo quase experimental com enfermeiros de uma unidade de terapia intensiva adulto, em que foi avaliado a retenção de conhecimento sobre o tema em três momentos: antes, uma semana e três meses após o treinamento. Resultados: Houve retenção significativa após uma semana, mas não aos três meses, sendo que aos três meses o índice de acertos nas questões foi expressivamente baixo em relação às fases anteriores. O desempenho dos participantes foi melhor nas questões relacionadas ao manuseio do sistema. Discussão: O tempo é um fator que interfere no aprendizado e os estudos mostram que o conhecimento aos 3 meses diminui significativamente, sendo que aos 6 meses e um ano quase que completamente. Condutas práticas baseadas em diretrizes de assistência tem melhor retenção entre os profissionais, ressaltando que há mais facilidade no aprendizado de habilidades técnicas que estão associadas a vivência profissional. Conclusões: Houve retenção de conhecimento significativa entre os profissionais na primeira semana após o treinamento, mas não aos três meses após o treinamento.


Introduction: Hydrocephalus is a common complication among neurological patients whose treatment in acute cases is done through an external ventricular drain catheter which allows monitoring and controlling intracranial hypertension. This study aimed at describing the knowledge retention by nurses after an educational intervention on nursing care for an external ventricular drain. Materials and Methods: A quasi-experimental study with nurses at an adult intensive care unit was conducted in which knowledge retention on the topic was evaluated at different three times: before, one week and three months after training. Results: After one week, significant retention was observed but not after three months, given that after this period the question success rate was significantly low with respect to the previous phases. Participants' performance was better in those questions related to system management. Discussion: Time is a factor that interferes with learning since studies show that knowledge at three months significantly decreases and is almost completely gone after six months and a year. Practical behaviors based on assistance guidelines have better retention among professionals, underlining that it is easier to learn technical skills that are associated with professional experience. Conclusions: A significant knowledge retention was observed among professionals in the first week after training but not after three months.


Introducción: La hidrocefalia es una complicación frecuente entre los pacientes neurológicos y su tratamiento en casos agudos se hace a través de un catéter de derivación ventricular externa que permite monitorear y controlar la hipertensión intracraneal. El objetivo de este estudio fue describir la retención del conocimiento de los enfermeros después de la intervención educativa sobre cuidados relativos a la derivación ventricular externa. Materiales y Métodos: Estudio cuasi experimental con enfermeros de una unidad de terapia intensiva de adultos, en el que se evaluó la retención del conocimiento sobre el tema en tres momentos: antes, una semana y tres meses después del entrenamiento. Resultados: Después de una semana se observó una retención significativa, sin embargo no a los tres meses, dado que después de tres meses el índice de aciertos en las preguntas fue significativamente bajo con respecto a las fases anteriores. El desempeño de los participantes fue mejor en las preguntas relacionadas con el manejo del sistema. Discusión: El tiempo es un factor que interfiere en el aprendizaje y los estudios muestran que el conocimiento a los tres meses disminuye significativamente, y después de seis meses y un año casi por completo. Las conductas prácticas basadas en directrices de asistencia tienen mejor retención entre los profesionales, resaltando que resulta más fácil aprender habilidades técnicas que están asociadas con la vivencia profesional. Conclusiones: Se observó una retención de conocimiento significativa entre los profesionales en la primera semana posterior al entrenamiento, pero no a los tres meses después del entrenamiento.


Subject(s)
Humans , Male , Female , Cerebrospinal Fluid , Knowledge , Inservice Training , Nursing Care
15.
San Salvador; s.n; 2020. 34 p. graf.
Thesis in Spanish | LILACS, BISSAL | ID: biblio-1151202

ABSTRACT

La criptococosis meníngea es el tipo más común de meningitis en adultos infectados con el Virus de Inmunodeficiencia Humana (VIH). El Cryptococcus neoformans es un hongo ubicuo que fue identificado como un patógeno humano en 1894, pero no fue reconocido como causa de morbilidad y mortalidad significativas en huéspedes con inmunidad celular comprometida hasta la década de 1970. Sin embargo, con el advenimiento de pacientes infectados con VIH en la década de 1980, las infecciones por criptococos se convirtieron en una causa más importante de enfermedad. De un total de 223,100 casos de criptococosis meníngea que se estima que ocurrieron a nivel mundial en personas que viven con el VIH en 2014, el tercer mayor número de casos en el mundo fueron de América Latina, con una incidencia estimada de 5.300 casos por año. De ellos, Brasil y Colombia fueron los países con mayor incidencia, entre 1,001 y 2,500 casos, seguidos por Argentina y México con una incidencia de 501 a 1,000 casos, de estos datos y otras estadísticas que documentan resultados similares es que se data la importancia de esta revisión pues se pretende demostrar la eficacia diagnostica de la tinta china y antígeno criptocócico en pacientes con diagnóstico de VIH/SIDA y co-infección de meningitis por criptococo y así demostrar la necesidad de las intervenciones de cada uno de los niveles de atención sanitaria en su manejo adecuado y oportuno. Esta revisión menciona las directrices actualizadas de la Organización Mundial de la Salud (OMS) donde subrayan la importancia del cribado en el punto de atención para permitir el inicio de la terapia con fluconazol para pacientes con recuentos de CD4 de menos de 100 células / ml y pruebas de antígeno criptocócico positivo en suero razón por la cual se estudia pues en áreas de recursos limitados donde la detección no está disponible o no son factibles, como la nuestra, la iniciación de fluconazol como tratamiento empírico y la profilaxis al momento del diagnóstico de VIH deben ser considerados en pacientes con recuentos bajos de CD44. Dicha revisión pretende buscar a través de revisiones sistemáticas, ensayos clínicos, metaanálisis, ensayos controlados aleatorizados y formato de texto completo, la pauta de manejo más acertada en nuestro medio pesar de las limitantes que se puedan tener


Subject(s)
Acquired Immunodeficiency Syndrome , Cerebrospinal Fluid , Internal Medicine , Meningitis
16.
Article in English | WPRIM | ID: wpr-828972

ABSTRACT

Real-time quaking-induced conversion (RT-QuIC) assay is a newly established PrP -detecting method. The development of RT-QuIC improves the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD), showing good sensitivity and specificity in many countries when the method was used in cerebrospinal fluid (CSF) samples. However, in China, the sensitivity and specificity of RT-QuIC has yet to be determined due to the lack of definitive diagnosis samples. Recently, 30 definitive sCJD and 30 non-CJD diagnoses were evaluated by RT-QuIC assay. In the 30 sCJD CSF samples, 29 showed positive results. By contrast, all the non-CJD samples were negative. The sensitivity and specificity of our RT-QuIC assay were 96.67% and 100%, respectively, and are comparable to other published data. Results can provide a fundamental basis for the usage of RT-QuIC assay in CJD surveillance in China.


Subject(s)
China , Creutzfeldt-Jakob Syndrome , Diagnosis , Diagnostic Tests, Routine , Methods , Humans , PrPSc Proteins , Cerebrospinal Fluid , Sensitivity and Specificity
18.
Article in English | WPRIM | ID: wpr-762475

ABSTRACT

BACKGROUND: Automated cellular analyzers are expected to improve the analytical performance in body fluid (BF) analysis. We evaluated the analytical performance of three automated cellular analyzers and established optimum reflex analysis guidelines. METHODS: A total of 542 BF samples (88 cerebrospinal fluid [CSF] samples and 454 non-CSF samples) were examined using manual counting and three automated cellular analyzers: UniCel DxH 800 (Beckman Coulter), XN-350 (Sysmex), and UF-5000 (Sysmex). Additionally, 2,779 BF analysis results were retrospectively reviewed. For malignant cell analysis, the receiver operating characteristic (ROC) curve was used, and the detection of high fluorescence-BF cells (HF-BFs) using the XN-350 analyzer was compared with cytology results. RESULTS: All three analyzers showed good agreement for total nucleated cell (TNC) and red blood cell (RBC) counts, except for the RBC count in CSF samples using the UniCel DxH 800. However, variable degrees of differences were observed during differential cell counting. For malignant cell analysis, the area under the curve was 0.63 for the XN-350 analyzer and 0.76 for manual counting. We established our own reflex analysis guidelines as follows: HF-BFs 83.4/100 WBCs or eosinophils >3.8% are the criteria for mandatory double check confirmation with 1,000× magnification examination. CONCLUSIONS: The three automated analyzers showed good analytical performances. Application of reflex analysis guidelines is recommended for eosinophils and HF-BFs, and manual confirmation is warranted.


Subject(s)
Body Fluids , Cell Count , Cerebrospinal Fluid , Eosinophils , Erythrocytes , Leukocytes , Reflex , Retrospective Studies , ROC Curve
19.
Article in Korean | WPRIM | ID: wpr-811245

ABSTRACT

Narcolepsy is a chronic neurological sleep disorder caused by hypocretin neuron loss, resulting in excessive daytime sleepiness, disturbed nocturnal sleep, and intrusions of aspects of rapid eye movement sleep in wakefulness, such as cataplexy, sleep paralysis, and hypnopompic/hypnagogic hallucinations. Narcolepsy disrupts the maintenance and orderly occurrence of the wake and sleep stages. Cataplexy is a highly specific symptom of narcolepsy, but many other symptoms can be observed in a variety of sleep disorders. The diagnosis of narcolepsy type 1 requires a history of excessive daytime sleepiness and one of the following : 1) a low cerebrospinal fluid hypocretin-1 level or 2) cataplexy and a positive multiple sleep latency test result. The diagnosis of narcolepsy type 2 requires a history of excessive daytime sleepiness and a positive mean sleep-latency test result. The mean sleep-latency test must be preceded by nighttime polysomnography to exclude other sleep disorders and to document adequate sleep. The mean sleep-latency test result can be falsely positive in other sleep disorders, such as shift work, sleep apnea, or sleep deprivation, and it is influenced by age, sex, and puberty. Modafinil and armodafinil can reduce the excessive daytime sleepiness without many of the side effects associated with older stimulants. Although there is no cure for narcolepsy, the treatments are often effective and include both behavioral and pharmacologic approaches.


Subject(s)
Adolescent , Cataplexy , Cerebrospinal Fluid , Diagnosis , Disorders of Excessive Somnolence , Hallucinations , Humans , Narcolepsy , Neurons , Orexins , Polysomnography , Puberty , Sleep Apnea Syndromes , Sleep Deprivation , Sleep Paralysis , Sleep Stages , Sleep Wake Disorders , Sleep, REM , Wakefulness
20.
Vaccimonitor (La Habana, Print) ; 28(3): 91-96, sept.-dic. 2019. graf
Article in Spanish | LILACS | ID: biblio-1094630

ABSTRACT

RESUMEN En los procesos neuroinflamatorios se produce a nivel de líquido cefalorraquídeo una activación policlonal y poliespecífica. Esta activación se produce desde los primeros días y puede permanecer por períodos prolongados. Luego por mecanismos de apoptosis los clones que no responden directamente contra los agentes biológicos involucrados no proliferan. El Reibergrama permite saber si las inmunoglobulinas presentes en el líquido cefalorraquídeo se sintetizaron o no en el sistema nervioso central (SNC) y el Índice de Anticuerpo (IA) determina la especificidad de las mismas en caso de que exista síntesis intratecal. Con estas herramientas nos propusimos identificar la respuesta neuroinmunológica frente a agentes de la familia herpesvirus en pacientes pediátricos con proceso inflamatorio del SNC a partir de sus respectivos IA. Para lograr esto se cuantificaron los niveles de IgG y albúmina en suero y líquido cefalorraquídeo (LCR) mediante inmunodifusión radial simple y por ensayo inmunoenzimático, con lo cual se construyó el Reibergrama que permitió la selección de 85 pacientes pediátricos con síntesis intratecal de inmunoglobulinas, que se diferenciaron en cuatro grupos según sus edades. Mediante ensayo inmunoenzimático se cuantificaron los niveles de IgG específica contra citomegalovirus, virus varicela zoster y virus herpes simple, tanto en suero como en LCR y se determinó el IA específico. La respuesta contra los virus estudiados fue similar para los distintos grupos de edades, lo cual nos permite afirmar la exposición temprana a los mismos.


ABSTRACT In a neuroinflammatory process a polyclonal and poly-specific activation is produced in cerebrospinal fluid. This activation starts from the first days and may persist for a long time. The clones not related directly against the biological agent do not proliferate by apoptosis. Reibergram determine if part of the immunoglobulins content in cerebrospinal fluid belongs from the blood or it is synthesized in the central nervous system. Antibody index determines if the specific antibodies was synthesized intrathecally. By these tools it can be possible to identify the humoral immune response against some herpes virus in pediatric patients suffering from a central nervous system inflammatory process. Quantification of specific IgG against citomegalovirus, varicella zoster and herpes simplex virus in serum and cerebrospinal fluid was done by ELISA. Specific Antibody index against these viruses were similar for the different age groups, which confirm the early exposure of the population.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Cerebrospinal Fluid , Simplexvirus , Cytomegalovirus Infections/diagnosis , Varicella Zoster Virus Infection/epidemiology , Epidemiology, Descriptive , Cross-Sectional Studies , Immunodiffusion/methods
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