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2.
Arq. neuropsiquiatr ; 79(10): 900-903, Oct. 2021. graf
Article in English | SES-SP, LILACS, SES-SP, CONASS, SESSP-ILSLPROD, SES-SP, SESSP-ILSLACERVO, SES-SP | ID: biblio-1345316

ABSTRACT

Abstract Background: Pruritus is a common complaint in dermatology. Wartenberg, in 1943, associated pruritus with neuropathy, relating it to the "posterior antebrachial cutaneous nerve neuropathy". In 1968, Waisman described patients with frequent pruritus complaints in the upper limb during the summer, which he named "brachioradial summer pruritus". Currently, this pruritus is named brachioradial pruritus (BRP). BRP is characterized by a chronic pruritus, usually localized, with a long duration, and without apparent cutaneous abnormalities. Neurological disorders both from the central and peripheral nervous systems, including multiple sclerosis, are associated with pruritus. Objective: To investigate correlations between symptomatic dermatomes and alterations in the myotomes, as evidenced by electroneuromyography (ENMG). Methods: Forty-six patients with BRP dermatological diagnoses were subjected to upper limb ENMG. Results: Among 46 patients with C5 to C8 dermatomal pruritus, we evaluated 113 symptomatic dermatomal areas. Overall, 39 (85%) patients had radicular involvement and 28 (60%) had agreement between complaint and the ENMG findings (p=0.015). A total of 80% of the patients with complaints at C7 and 47% at C6 had radicular involvement at the same level. Conclusions: Among the patients who presented complaints, 47 and 80%, respectively, had ENMG alterations in the C6 and C7 myotomes. We conclude that peripheral nervous system involvement is associated with BRP.


RESUMO Antecedentes: O prurido constitui queixa frequente e desafiadora na prática dermatológica. O primeiro estudo a relacionar prurido com neuropatia foi de Wartenberg, em 1943, que associou à "neuropatia do nervo cutâneo antebraquial posterior". Em 1968, Waisman descreveu pacientes com queixas recorrentes de prurido em membros superiores no verão, sendo denominado, então, "brachioradial summer pruritus". Atualmente, esse prurido é denominado como prurido braquiorradial (PBR). O PBR é caracterizado por prurido crônico, geralmente bem localizado, de longa duração e sem anormalidades cutâneas aparentes. Doenças neurológicas, tanto centrais, esclerose múltipla ou acidente vascular cerebral como do sistema nervoso periférico, estão associadas a prurido. Objetivo: Investigar os dermátomos sintomáticos pela eletroneuromiografia (ENMG). Métodos: Foram estudados 46 pacientes com diagnóstico dermatológico de PBR com a eletroneuromiografia dos membros superiores. Resultado: Foram avaliados 46 pacientes com queixa dermatológica de C5 a C8 somando 113 áreas dermatoméricas sintomáticas. Observou-se que 39 (85%) pacientes apresentavam comprometimento radicular, sendo que em 28 (60%) houve concordância plena entre as queixas e os achados da ENMG (p=0,015), e que 80% dos pacientes com queixa em território de C7 e 47% em C6 apresentavam comprometimento radicular no mesmo nível. Conclusões: As queixas mais frequentes foram as correspondentes aos territórios de C6 e C7, sendo que 47 e 80%, respectivamente, apresentaram alteração na ENMG nesses miótomos. Dessa forma, evidenciou-se correlação entre comprometimento do sistema nervoso periférico (i.e., radicular) com PBR.


Subject(s)
Humans , Pruritus , Peripheral Nervous System , Arm , Radiculopathy , Electromyography , Muscles , Nervous System Diseases
3.
Rev. colomb. anestesiol ; 49(3): e600, July-Sept. 2021. tab, graf
Article in English | LILACS, COLNAL | ID: biblio-1280183

ABSTRACT

Abstract Tuberous sclerosis (TSC) is a rare disease with multi-systemic involvement, predominantly neurological. Little evidence exists about the anesthetic management of patients with this disorder, particularly in pregnant women. This article discusses a case of a patient with TSC admitted to our hospital for the delivery of a twin gestation. Twenty-four hours after surgery, the patient presented left-side facial-brachial hypoesthesia and headache. A brain CT revealed a right frontal cortical bleeding tumor, which was diagnosed as glioblastoma multiforme. The patient was discharged 15 days after admission and a neurosurgical approach was suggested.


Resumen La esclerosis tuberosa es una enfermedad poco frecuente asociada con compromiso multisistémico, principalmente neurológico. Es poca la evidencia sobre el manejo anestésico de los pacientes con este trastorno, en particular las mujeres embarazadas. En este artículo presentamos el caso de una paciente con esclerosis tuberosa ingresada en nuestro hospital para el parto de una gestación gemelar. Veinticuatro horas después de la cirugía, la paciente presentó hipoestesia facial y braquial izquierda y cefalea. La tomografía cerebral mostró un tumor cortical sangrante en el lóbulo frontal derecho, diagnosticado como glioblastoma multiforme. La paciente fue dada de alta 15 días después de su ingreso y, con recomendación de manejo por neurocirugía.


Subject(s)
Humans , Female , Pregnancy , Cesarean Section , Glioblastoma , Headache , Anesthesia, Epidural , Anesthetics , Neurosurgery , Tuberous Sclerosis , Brain , Rare Diseases , Parturition , Hemorrhage , Hospitals , Hypesthesia , Neoplasms , Nervous System Diseases
4.
Arq. bras. med. vet. zootec. (Online) ; 73(4): 916-922, Jul.-Aug. 2021. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1285267

ABSTRACT

This study characterized the clinical, radiological, ultrasound, and necroscopic findings of a case of Arnold-Chiari type II malformation in a Gir breed calf from Brazil. The animal was hospitalized at sixty days of age, in permanent sternal recumbency, cutaneous appendix at the 4th lumbar vertebra and kyphoscoliosis of the caudal and lumbosacral thoracic spine. Radiographic examination of the spine and skull revealed spina bifida and suspected occipital hypoplasia. Upon examination of myelography with an injection of lumbar and atlantooccipital contrast, it was possible to visualize the meningocele at the 4th lumbar vertebra region and findings at the rhombencephalon level of increased regional pressure with failure to fill the contrast in the posterior fossa, in the presence of clear demarcation of the circumvolutions of the cerebral cortex and the subarachnoid space of the cervical spinal cord. Ultrasonographic examination of the cerebellum showed an insinuation of the cerebellar worm through the foramen magnum. The animal did not show changes in complete blood count, biochemical series, and cerebrospinal fluid and was negative for Pestivirus. There was a worsening of the clinical conditions and the animal died. This malformation of unknown etiology must be studied as a differential diagnosis of the nervous system disorders.(AU)


Este estudo caracterizou os achados clínicos, radiológicos, ultrassonográficos e necroscópicos de um caso de malformação de Arnold-Chiari tipo II em uma bezerra Gir no Brasil. O animal foi hospilatizado aos 60 dias de idade, apresentando decúbito esternal permanente, apêndice cutâneo na altura da quarta vértebra lombar e cifoescoliose da coluna vertebral torácica caudal e lombossacra. Ao exame radiográfico da coluna e do crânio, foram observadas espinha bífida e suspeita de hipoplasia occipital. Ao exame de mielografia com injeção de contraste lombar e atlanto-occipital, foi possivel visualizar a meningocele na altura da quarta vértebra lombar e achados em nível rombencefálico de aumento da pressão regional com falha de preenchimento do contraste na fossa posterior, na presença de nítida demarcação das circunvoluções do córtex cerebral e do espaço subaracnoide da medula espinhal cervical. Ao exame ultrassonográfico do cerebelo, foi observada insinuação do verme cerebelar através do forame magno. O animal não apresentou alterações em hemograma completo, série bioquímica e fluido cérebro-espinhal e foi negativo para Pestivirus. Houve uma piora do quadro clínico e o animal morreu. Essa malformação de etiologia desconhecida deve ser estudada como um diagnóstico diferencial.(AU)


Subject(s)
Animals , Female , Cattle , Arnold-Chiari Malformation/veterinary , Arnold-Chiari Malformation/diagnostic imaging , Cerebellar Vermis/diagnostic imaging , Congenital Abnormalities/veterinary , Nervous System Diseases/diagnostic imaging
5.
Rev. cuba. anestesiol. reanim ; 20(2): e688, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1289349

ABSTRACT

Introducción: El accidente cerebrovascular es una de las causas más comunes de mortalidad a nivel mundial. Objetivo: Determinar la asociación existente entre el desarrollo de afecciones neurológicas y la necesidad de ventilación mecánica con el aumento de la incidencia de mortalidad en la unidad de cuidados intensivos. Métodos: Estudio observacional, prospectivo de corte transversal, realizado en la unidad de cuidados intensivos de un hospital de atención secundaria. La población de estudio estuvo constituida por 52 pacientes con accidente cerebrovascular los cuales recibieron soporte respiratorio artificial entre los años 2018 y 2020. La variable de interés final fue la mortalidad. Los factores neurológicos estudiados fueron el tipo de accidente cerebrovascular, puntuación de la escala de coma de Glasgow, ausencia de reflejos de tallo encefálico, anisocoria y complicaciones neurológicas. El nivel de significación se halló según p valor ≤ 0,05 a través de Chi cuadrado de independencia. Resultados: La mortalidad proporcional predominó en el accidente cerebrovascular hemorrágico tipo hemorragia intracraneal no traumática (p= 0,118), ausencia de reflejos del tallo encefálico (p=0,000), anisocoria (p=0,000), escala de coma de Glasgow <8 puntos (p=0,000) y complicaciones neurológicas como la hipertensión endocraneana (p=0,010). Conclusiones: Los factores neurológicos asociados a la mortalidad fueron la ausencia de reflejos del tallo encefálico, anisocoria, escala de coma de Glasgow <8 puntos y complicaciones neurológicas como la hipertensión endocraneana(AU)


Introduction: Cerebrovascular accident is one of the commonest causes of mortality in the world. Objective: To determine the association between development of neurological disorders and the need for mechanical ventilation with an increased incidence of mortality in the intensive care unit. Methods: An observational, prospective and cross-sectional study was carried out in the intensive care unit of a secondary care hospital. The study population consisted of 52 patients with cerebrovascular accident who received artificial respiratory support between 2018 and 2020. The final variable of interest was mortality. The neurological factors studied were type of cerebrovascular accident, score according to the Glasgow coma scale, absence of brainstem reflexes, anisocoria, and neurological complications. The level of significance was determined according to P ≤ 0.05, through chi-square of independence. Results: Proportional mortality prevailed in hemorrhagic cerebrovascular accident of nontraumatic intracranial hemorrhage type (P=0.118), absence of brainstem reflexes (P=0.000), anisocoria (P=0.000), score of less than eight points according to the Glasgow coma scale (P=0.000), and neurological complications such as endocranial hypertension (P=0.010). Conclusions: The neurological factors associated with mortality were absence of brainstem reflexes, anisocoria, score of less than eight points according to the Glasgow coma scale, and neurological complications such as endocranial hypertension(AU)


Subject(s)
Humans , Stroke/mortality , Respiration, Artificial/adverse effects , Secondary Care , Cross-Sectional Studies , Prospective Studies , Intensive Care Units , Nervous System Diseases/complications
6.
Rev. Assoc. Méd. Rio Gd. do Sul ; 65(2): 01022105, Abr. - Jun. 2021.
Article in Portuguese | LILACS | ID: biblio-1367450

ABSTRACT

RESUMO Introdução: As doenças genéticas, em crianças, abrangem uma ampla gama de condições e causas variadas. Objetivo: Verificar a frequência de doenças neurogenéticas em pacientes pediátricos de 0 a 5 anos atendidos em um ambulatório universitário, e os fatores associados. Métodos: estudo de coorte retrospectivo, realizado com pacientes pediátricos atendidos em 2017, em um ambulatório materno infantil da Universidade do Sul de Santa Catarina. Os dados foram obtidos dos prontuários físicos dos pacientes, exclusivos do serviço de neurogenética. Resultados: Foram analisados 82 prontuários de crianças acompanhadas pelo serviço de neurogenética em 2017. A idade das crianças variou entre um mês e um dia e 5,42 anos, sendo 28,0% com um ano completo. A consanguinidade dos pais foi reportada em cinco (6,1%) casos. As principais intercorrências maternas citadas durante a gestação resumiram-se em infecção por citomegalovírus, rubéola, toxoplasmose (2,4%) e infecção do trato urinário (19,5%). Os registros de complicações no ato do nascimento, foram PCR (2,4%), anóxia (1,2%) e Apgar baixo (3,7%). Quanto às intercorrências do neonato no pós-parto, as principais citações foram infecções (19,5%), traumas (20,7%), cirurgia (36,6%) e EIM (30,5%), sendo que um mesmo paciente pode ter apresentado mais de uma intercorrência. Como queixa principal, 23 (28,05%) dos pais referiam atraso no desenvolvimento neuropsicomotor das crianças. Como diagnóstico principal, 15,9% constaram Síndrome de Down e 12,3% Transtorno do Espectro Autista. Conclusão: O conhecimento do perfil de crianças acometidas por doenças neurogenéticas é imprescindível para a obtenção do diagnóstico precoce, do tratamento efetivo e melhor prognóstico da doença. PALAVRAS-CHAVE: Doenças do sistema nervoso, genética, pré-escolar, estudos epidemiológicos


ABSTRACT Introduction: Genetic diseases in children encompass a wide range of conditions and varied causes. Purpose: To verify the frequency of neurogenetic diseases in pediatric patients aged 0-5 years seen at a university outpatient clinic, and associated factors. Methods: A retrospective cohort study, carried out with pediatric patients seen at a maternal and child clinic at Universidade do Sul de Santa Catarina in 2017. Data were obtained from the patients' physical records, exclusive to the neurogenetics service. Results: 82 medical records of children followed by the neurogenetics service in 2017 were analyzed. The children's age ranged from 01 month and one day to 5.42 years, 28.0% over one year old. Parental consanguinity was reported in five (6.1%) cases. The main maternal complications mentioned during pregnancy were cytomegalovirus infection, rubella, toxoplasmosis (2.4%) and urinary tract infections (19,5%). The records of complications at birth were CRP (2.4%), anoxia (1.2%) and Low Apgar (3.7%). As for the complications of the newborn in the postpartum period, the main citations were infections (19.5%), trauma (20.7%), surgery (36.6%) and IEM (30.5%), but a patient may have had more than one complication. As the main complaint, 23 (28.05%) of the parents reported delay in their children's neuropsychomotor development. As the main diagnosis, 15.9% had Down Syndrome and 12.3% had Autistic Spectrum Disorder. Conclusion: Knowledge of the profile of children affected by neurogenetic diseases is essential to obtain an early diagnosis, effective treatment and a better prognosis of the disease. KEYWORDS: Nervous system diseases, genetics, preschool, epidemiologic studies


Subject(s)
Humans , Child, Preschool , Epidemiologic Studies , Genetics , Nervous System Diseases
7.
Medicina (B.Aires) ; 81(2): 208-213, June 2021. graf
Article in Spanish | LILACS | ID: biblio-1287272

ABSTRACT

Resumen El manejo de las reacciones adversas inducidas por los inhibidores del punto de control inmunitario (IPCI) en cáncer, demanda un trabajo multidisciplinario. Revisamos las causas y el curso clínico de las consultas e internaciones debidas a reacciones adversas de los IPCI entre septiembre de 2015 y julio de 2019 en el Instituto Alexander Fleming. Se registraron los datos demográficos, diagnóstico oncológico, reacción adversa y su grado, requerimiento de internación, tratamiento, mortalidad y evaluación de la reexposición. Se registraron 124 reacciones adversas por IPCI en 89 pacientes. Sesenta y ocho recibían monoterapia y 21 terapia combinada. Las manifestaciones cutáneas fueron las más frecuentes, seguidas de las generales, endocrinas (con mayor frecuencia hipotiroidismo), colitis, neumonitis, neurológicas y hepatitis. Fueron graves (grado ≥ 3), 26 toxicidades en 25 pacientes. Se internaron 15, y 6 de ellos requirieron terapia intensiva. Un caso fue fatal. Recibieron glucocorticoides 34 (12 de ellos por vía intravenosa). Un paciente recibió micofenolato y uno inmuno globulina endovenosa. En 20 se discontinuó el tratamiento. Ocho se reexpusieron y uno de ellos debió suspender definitivamente. Se presenta en esta serie de casos nuestra experiencia con el diagnóstico y tratamiento de las reacciones adversas de una familia de drogas cuya utilización ha crecido en los últimos años.


Abstract The management of patients with immune-related adverse events (irAEs) frequently demands a multidisciplinary approach. We reviewed the causes and clinical course of medical visits and admissions at the Instituto Alexander Fleming due to irAEs between September 2015 and July 2019. Demographic data, diagnosis, toxicity and its severity, requirement of admission, treatment, mortality, and evaluation of the re-administration of immunotherapy were collected. We found 124 irAEs in 89 patients. Sixty-eight of them received monotherapy (76.4%) and 21 (23.6%) combination of drugs. Cutaneous manifestations were the most frequent cause of irAEs, followed by general manifestations, endocrine dysfunctions (hypothyroidism the most frequent), colitis, pneumonitis, neurologic dis orders, and hepatitis. In 26 adverse events (in 25 patients), severity grade was ≥ 3. Fifteen were admitted and 6 required ICU admission. One patient died. Thirty-four received glucocorticoids, 12 of them by intravenous route. One patient received mycophenolate and one IVIG. In 20, the treatment was discontinued; 8 were re-exposed, with definitive discontinuation in one patient. In this case series we report our experience in the diagnosis and management of adverse reactions related to a family of drugs whose use has grown in recent years.


Subject(s)
Humans , Drug-Related Side Effects and Adverse Reactions , Neoplasms/drug therapy , Nervous System Diseases , Immune Checkpoint Inhibitors , Immunologic Factors/therapeutic use , Immunotherapy
8.
Rev. bras. ter. intensiva ; 33(2): 325-325, abr.-jun. 2021. tab
Article in English, Portuguese | LILACS | ID: biblio-1289082

ABSTRACT

RESUMO A COVID-19 foi declarada pandemia pela Organização Mundial de Saúde no dia 11 de março de 2020. O quadro clínico apresenta predominantemente sintomatologia respiratória, no entanto, na literatura atual, têm sido descritas diversas manifestações neurológicas associadas à infeção por SARS-CoV-2. Os autores apresentam o caso clínico de um homem de 45 anos internado por pneumonia com resultado positivo para SARS-CoV-2, sem antecedentes neurológicos, que, ao décimo sexto dia de internamento, apresentou alteração súbita do estado de consciência acompanhada de desvio conjugado do olhar para a direita e mioclonias da face e da região torácica à esquerda, seguidas de crise convulsiva tônico-clônica generalizada, associadas à hemiparesia esquerda persistente. Do estudo realizado salienta-se a existência de RT-PCR para SARS-CoV-2 no líquido cefalorraquidiano positiva. O doente apresentou evolução clínica com melhoria gradual, tendo o desfecho sido favorável.


ABSTRACT COVID-19 was declared a pandemic by the World Health Organization on March 11, 2020. The clinical presentation is predominantly respiratory symptoms; however, in the current literature, several neurological manifestations associated with SARS-CoV-2 infection have been described. The authors present the clinical case of a 45-year-old man hospitalized for pneumonia with a positive test result for SARS-CoV-2, without a neurological history, who, on the sixteenth day of hospitalization, presented a sudden change in his state of consciousness accompanied by conjugated right gaze deviation and myoclonus of the face and thoracic region to the left, followed by generalized tonic-clonic seizures associated with persistent left hemiparesis. The present study highlights a positive RT-PCR test for SARS-CoV-2 in cerebrospinal fluid. The patient progressed with gradual improvement, and the outcome was favorable.


Subject(s)
Humans , Male , Middle Aged , SARS-CoV-2/isolation & purification , COVID-19/complications , Nervous System Diseases/virology , Pneumonia, Viral/diagnosis , Seizures/virology , Hospitalization , Nervous System Diseases/physiopathology
9.
Article in Chinese | WPRIM | ID: wpr-888171

ABSTRACT

Astragali Radix is a traditional Chinese herbal medicine with a long history, which has the functions of tonifying Qi and promoting urination and granulation. Astragalosides are the main effective components of Astragali Radix, and more than 40 triterpenoid saponins have been obtained from Astragalus membranaceus and its related plants, mainly including astragalosides Ⅰ-Ⅷ, isoastragalosides Ⅰ, Ⅱ, and Ⅳ, acetylastragalosides, and soyasaponins. Astragalosides have a wide range of biological activities, such as immunomodulation, antioxidation, and neuroprotection. Nervous system diseases seriously affect people's quality of life, threaten human physical and mental health, and impose a burden on families and society. As natural drugs, astragalosides have good preventive and therapeutic effects on central nervous system diseases. This paper reviews the main pharmacological effects and mechanisms of astragalosides in the treatment of multiple sclerosis, Parkinson's disease, Alzheimer's disease, and cerebral ischemic stroke and proposes the research prospects and potential problems, aiming to provide reference for the clinical application and basic research of astragalosides.


Subject(s)
Astragalus Plant , Astragalus propinquus , Drugs, Chinese Herbal , Humans , Nervous System Diseases , Quality of Life , Saponins/pharmacology
10.
Chinese Journal of Biotechnology ; (12): 3757-3780, 2021.
Article in Chinese | WPRIM | ID: wpr-921463

ABSTRACT

The human intestinal flora is a highly diverse ecosystem composed of trillions of bacteria. The imbalance of the flora is related to a variety of diseases. The intestinal flora interacts with the nervous system bidirectionally in many ways through the gut-brain axis. It causes neuroimmune inflammatory response, dysfunction of gut mucosa and blood-brain barrier, direct stimulation of the vagus nerve, spinal nerve of the enteric nervous system, and the neuroendocrine hypothalamus-pituitary-adrenal axis, causing neurological disorders. The metabolites of the intestinal microbial community also play a role. This article summarizes the characteristics of the altered intestinal flora and intervention measures in autism spectrum disorder, multiple sclerosis, Parkinson's disease, epilepsy, Guillain-Barré syndrome, Alzheimer's disease, neuromyelitis optica, hepatic encephalopathy, amyotrophic lateral sclerosis, schizophrenia, depression, chronic fatigue syndrome, Huntington's disease and stroke. The current research on intestinal flora is still in its infancy, and very few studies were carried out on causality and the underlying mechanisms, which prevents the development of precise flora-based clinical intervention measures. It is expected the research on intestinal flora would lead to novel approaches for treatment of some neurological disorders.


Subject(s)
Autism Spectrum Disorder , Brain , Gastrointestinal Microbiome , Humans , Microbiota , Nervous System Diseases
11.
Article in English | WPRIM | ID: wpr-888606

ABSTRACT

BACKGROUND@#Particulate matter (PM), a major component of ambient air pollution, accounts for a substantial burden of diseases and fatality worldwide. Maternal exposure to PM during pregnancy is particularly harmful to children's health since this is a phase of rapid human growth and development.@*METHOD@#In this review, we synthesize the scientific evidence on adverse health outcomes in children following prenatal exposure to the smallest toxic components, fine (PM@*RESULTS@#Maternal exposure to fine and ultrafine PM directly and indirectly yields numerous adverse birth outcomes and impacts on children's respiratory systems, immune status, brain development, and cardiometabolic health. The biological mechanisms underlying adverse effects include direct placental translocation of ultrafine particles, placental and systemic maternal oxidative stress and inflammation elicited by both fine and ultrafine PM, epigenetic changes, and potential endocrine effects that influence long-term health.@*CONCLUSION@#Policies to reduce maternal exposure and health consequences in children should be a high priority. PM


Subject(s)
Adult , Air Pollutants/adverse effects , Air Pollution/prevention & control , Animals , Cardiovascular Diseases/chemically induced , Child Health , Child, Preschool , Disease Models, Animal , Endocrine System Diseases/chemically induced , Epigenomics , Female , Humans , Immune System Diseases/chemically induced , Infant , Infant, Newborn , Male , Maternal Exposure/adverse effects , Nervous System Diseases/chemically induced , Oxidative Stress , Particle Size , Particulate Matter/adverse effects , Placenta , Pregnancy , Pregnancy Outcome/epidemiology , Prenatal Exposure Delayed Effects/epidemiology , Respiratory Tract Diseases/chemically induced , Young Adult
12.
Article in Chinese | WPRIM | ID: wpr-879889

ABSTRACT

Coronavirus disease 2019 (COVID-19) has become a worldwide pandemic and can occur at any age, including children. Children with COVID-19 can develop the clinical symptoms of multiple systems, among which symptoms of the nervous system have been reported increasingly, and thus it is particularly important to understand COVID-19-associated neurological damage in children. This article reviews the mechanisms and types of COVID-19-associated neurological damage in children.


Subject(s)
COVID-19 , Child , Humans , Nervous System Diseases , Pandemics , SARS-CoV-2
13.
Rev. enferm. UFSM ; 11: e72, 2021. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1342112

ABSTRACT

Objetivo: identificar os danos neurológicos prevalentes em pacientes internados em Unidade de Terapia Intensiva e a relação destes com as características sociais e clínicas, os cuidados e o desfecho clínico. Método: estudo transversal com análise de 83 prontuários de pacientes com danos neurológicos e internados no período de 2016 a 2018. Resultados: predomínio do Acidente Vascular Encefálico Hemorrágico (55,4%). O Traumatismo Cranioencefálico acometeu apenas homens (16,9%). A Hipertensão Arterial Sistêmica foi a principal comorbidade evidenciada (51,8%). A alteração da força muscular foi o principal sinal de dano neurológico grave (36,2%). A analgesia prevaleceu entre os cuidados intensivos dedicados aos pacientes com danos neurológicos graves (95,1%). Predomínio do óbito como desfecho clínico (85,6%). Conclusão: predomina o Acidente Vascular Encefálico Hemorrágico, especialmente em mulheres. A analgesia é o principal cuidado evidenciado, e a taxa de mortalidade foi superior à dos índices encontrados na literatura.


Objective: to identify the prevalent neurological damage in patients admitted to an Intensive Care Unit and their relationship with social and clinical characteristics, care, and clinical outcome. Method: cross-sectional study with analysis of 83 medical records of patients with neurological damage and hospitalized in the period from 2016 to 2018. Results: predominance of Hemorrhagic Stroke (55.4%). Traumatic Brain Injury affected only men (16.9%). Systemic Arterial Hypertension was the main comorbidity evidenced (51.8%). Altered muscle strength was the main sign of severe neurological damage (36.2%). Analgesia prevailed among intensive care dedicated to patients with severe neurological damage (95.1%). Death as clinical outcome predominated (85.6%). Conclusion: Hemorrhagic stroke predominates, especially in women. Analgesia is the main care evidenced, and the mortality rate was higher than the rates found in the literature.


Objetivo: identificar el daño neurológico prevalente en los pacientes ingresados en una Unidad de Cuidados Intensivos y su relación con las características sociales y clínicas, los cuidados y el resultado clínico. Método: estudio transversal con análisis de 83 historias clínicas de pacientes con daño neurológico e ingresados en el periodo de 2016 a 2018. Resultados: predominio del Ictus Hemorrágico (55,4%). El traumatismo craneoencefálico sólo afectaba a los hombres (16,9%). La hipertensión arterial sistémica fue la principal comorbilidad evidenciada (51,8%). La alteración de la fuerza muscular fue el principal signo de daño neurológico grave (36,2%). La analgesia prevaleció entre los cuidados intensivos dedicados a los pacientes con daño neurológico grave (95,1%). Predominó la muerte como resultado clínico (85,6%). Conclusión: Predomina el ictus hemorrágico, especialmente en las mujeres. La analgesia es el principal cuidado evidenciado, y la tasa de mortalidad fue superior a las tasas encontradas en la literatura.


Subject(s)
Humans , Health Profile , Adult , Intensive Care Units , Nervous System Diseases , Neurologic Manifestations
14.
Rev. Investig. Salud. Univ. Boyacá ; 8(1): 170-185, 20210000.
Article in Spanish | LILACS, COLNAL | ID: biblio-1358975

ABSTRACT

Introducción: La fiebre se considera uno de los primeros síntomas registrados en pacientes hospitalizados y se ha convertido en un importante marcador de enfermedad. La presente revisión buscó recopilar evidencia en torno a la fiebre y su importancia en los diferentes escenarios clínicos que se presentan en el paciente neurológico, ya que en los últimos años se ha logrado comprender mejor el papel que desempeña el sistema nervioso central dentro de la termorregulación. Metodología: Búsqueda de la literatura en bases de datos como Pubmed, OVID, Epistemonikos, SciELO y Google Scholar, durante los años 2009 al 2019 en español e inglés, sobre fiebre e implicaciones en pacientes neurológicos, usando palabras clave como fiebre, sensibilidad, especificidad, likelihood ratio, enfermedades del sistema nervio-so, neurología, encefalitis, neuritis y traumatismo del sistema nervioso. Resultados: Se encontraron 374 artículos, de los cuales 48 cumplieron con los criterios de inclusión. Se incluyeron libros de texto, como metaanálisis, revisiones sistemáticas, revisiones scoping, artículos de revisión y estudios ob-servacionales. Se analizaron y subdividieron en 8 apartados con temáticas en común para su estudio. Conclusiones: En etapas tempranas de eventos cerebro-vasculares isquémicos o hemorrágicos la fiebre se com-porta como una respuesta sistémica secundaria al daño de base, y es crucial corregirla tempranamente. Al mismo tiempo, en traumatismos del sistema nervioso central, la fiebre en las primeras 72 horas se identifica como un marcador de mal pronóstico


Introduction: Fever is considered one of the first symptoms registered in hospitalized patients, beco-ming an important marker of disease. The present review sought to collect evidence on fever and its importance in the different clinical scenarios that occur in neurological patients, since in recent years it has been possible to better understand the role of the central nervous system within the thermo-regulation. Methodology: A literature search was carried out in databases such as Pubmed, OVID, Epistemoni-kos, SciELO and Google Scholar during the years 2009 to 2019 in Spanish and English languages, on fever and implications in neurological patients, using keywords such as fever, sensitivity, specificity, likelihood ratio, diseases of the nervous system, neurology, encephalitis, neuritis and trauma of the nervous system. Results: A total of 374 articles were found, of which 48 articles met the inclusion criteria, for the construction of this review article. Textbooks, as well as meta-analyzes, systematic reviews, scoping reviews, and review articles were included. They were analyzed and subdivided into 8 sections with common themes for their study. Conclusions: In early stages of ischemic or hemorrhagic CVD, fever behaves as a systemic response secondary to the underlying injury, and it is crucial to correct it early. At the same time, in CNS trauma, fever in the first 72 hours is identified as a poor prognostic marker


Introdução: A febre é considerada um dos primeiros sintomas registrados em pacientes hospitaliza-dos e tornou-se um importante marcador de doença. A presente revisão procurou reunir evidencias em torno da febre e sua importância nos diferentes panoramas clínicos no paciente neurológico, uma vez que nos últimos anos foi possível compreender melhor o papel do sistema nervoso central no processo de termo regulação. Metodologia: Foi realizada uma pesquisa de literatura em bases de dados como Pubmed, OVID, Epis-temonikos, SciELO e Google Acadêmico, durante os anos 2009 a 2019 em espanhol e inglês, sobre febre e suas implicações em pacientes neurológicos, utilizando palavras-chave como febre, sensibili-dade, especificidade, likelihood ratio, doenças do sistema nervoso, neurologia, encefalite, neurite e trauma do sistema nervoso. Resultados: Foi encontrado um total de 374 artigos, dos quais 48 abrangiam os critérios de inclusão. Foram incluídos livros de texto, como meta-análises, revisões sistemáticas, revisões Scoping, artigos de revisão e estudos observacionais. Foram analisadas e subdivididas em 8 secções com assuntos comuns para seu estudo. Conclusões: Em fases iniciais de eventos cerebrovasculares isquêmicos ou hemorrágicos, a febre se comporta como uma resposta sistêmica secundária ao dano de base, e é crucial corrigi-la precoce-mente. Enquanto, em traumatismos do sistema nervoso central, a febre nas primeiras 72 horas é identificada como um marcador de mau prognóstico


Subject(s)
Fever , Diagnosis , Nervous System Diseases , Neurology
15.
Rev. cuba. med ; 59(4): e1162, oct.-dic. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1144507

ABSTRACT

Introducción: Los trastornos neurológicos asociados al dengue es un tema que cobra vital importancia en estos tiempos debido a que el espectro clínico del dengue ha cambiado y las manifestaciones atípicas están reportándose con mayor frecuencia. Los serotipos 2 y 3 son los más frecuentemente relacionados a manifestaciones neurológicas como la encefalitis, mielitis y síndrome de Guillain-Barré. Objetivo: Reportar una serie de casos con trastornos neurológicos asociados a la infección por DENV y sus variables clínicas, humorales e imagenológicas. Casos clínicos: Todos los pacientes cursaron en primera instancia con un cuadro clínico de dengue no complicado dado por fiebre de 38,5º C y escalofríos de aparición brusca, exantema maculo-papuloso céfalo-caudal que respeta palmas y plantas, artralgias, mialgias, cefalea frontal y retro-ocular, esta última a la contracción del músculo recto superior del globo ocular. Todos confirmados con anticuerpos específicos anti-virus del dengue. Un paciente desarrolló síndrome de Guillain-Barré, otro curso con encefalitis, bicitopenia y compromiso del nivel de conciencia. El resto cursó con mielitis transversa, meningoencefalitis y encefalitis autoinmune. Conclusiones: Los trastornos neurológicos asociados al virus del dengue deben ser sospechados en todo paciente que ingrese con esta infección y manifieste cualquiera de las alteraciones aquí descritas(AU)


Introduction: Neurological disorders associated with dengue is an issue of vital importance in these times because the clinical spectrum of dengue has changed and atypical manifestations are being reported much frequently. Serotypes 2 and 3 are the most frequently related to neurological manifestations such as encephalitis, myelitis and Guillain-Barré syndrome. Objective: To report a series of cases with neurological disorders associated with DENV infection and its clinical, humoral and imaging variables. Clinical case report: All patients had, in the first instance, uncomplicated dengue clinical status due to 38.5º C fever and chills of sudden appearance, Cephalo-caudal maculo-papular rash that spares palms and soles, arthralgias, myalgias, frontal and retro-ocular headache, the latter due to the contraction of the superior rectus muscle of the eyeball. All confirmed with specific anti-dengue virus antibodies. One patient developed Guillain-Barré syndrome, another had encephalitis, bicytopenia, and compromised level of consciousness. The rest had transverse myelitis, meningoencephalitis and autoimmune encephalitis. Conclusions: Neurological disorders associated with dengue virus should be suspected in every patient who is admitted with this infection and manifests any of the alterations described here(AU)


Subject(s)
Humans , Male , Female , Dengue/complications , Nervous System Diseases/complications
17.
Arch. argent. pediatr ; 118(5): e480-e485, oct 2020. ilus, tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1122533

ABSTRACT

Se presentan dos pacientes que desarrollaron deterioro visual debido a una intoxicación por monóxido de carbono. Ellos fueron tratados con oxígeno hiperbárico y recuperaron no solo su visión, sino que, además, mejoraron su signo-sintomatología neurológica. Se cree que la implementación de oxígeno hiperbárico, incluso en un período tardío, será efectiva para revertir las secuelas neurológicas.


We present two patients who developed visual deterioration due to carbon monoxide poisoning. They were treated with hyperbaric oxygen and recovered not only their vision but also they improved neurological signs and symptoms. We believe that implementation of hyperbaric oxygen, even in a late period of time will be effective in reversing neurological sequela


Subject(s)
Humans , Male , Child , Adolescent , Carbon Monoxide Poisoning/complications , Blindness/chemically induced , Hyperbaric Oxygenation , Nervous System Diseases/chemically induced
18.
Acta pediátr. hondu ; 11(1): 1136-1141, abr.- sept. 2020.
Article in Spanish | LILACS | ID: biblio-1145394

ABSTRACT

El nuevo coronavirus se origino en la ciudad de Wuhan, China, esta enfermedad afecta principalmente el sistema respiratorio, los síntomas pueden ir desde leves a severos, así también, existe otra variedad de presentaciones clínicas en otros sistemas, como es el sistema nervioso central, actualmente existe evidencia de gran cantidad de publicaciones de presentación neurológica como manifestaciones de COVID-19. Actualmente se ha descrito el potencial neurotrópico del coronavirus para invadir el sistema nervioso central y también se ha descrito diversos mecanismos de daño secundario. Las diferentes presentaciones neurológicas en niños como en adultos pueden ser variables, y estas incluyen manifestaciones del sistema nervios central, periférico y enfermedades musculares...(AU)


Subject(s)
Humans , Central Nervous System , Coronavirus Infections/diagnosis , Peripheral Nervous System , Nervous System Diseases/complications
19.
Rev. cuba. invest. bioméd ; 39(3): e868, jul.-set. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1138946

ABSTRACT

Introducción: Los coronavirus infectan al ser humano y pueden causar manifestaciones neurológicas en individuos susceptibles. Objetivo: Describir la patogenia de las manifestaciones neurológicas en pacientes con la COVID-19. Estrategia de búsqueda y criterios de selección: Se realizó una revisión bibliográfica empleando la bibliografía nacional e internacional actualizada. Se realizó la búsqueda en Google Académico, se consultaron artículos de libre acceso en las bases de datos Pubmed y SciELO, desde enero de 2014 hasta el 6 de mayo de 2020. Fueron seleccionados 51 artículos (6 en idioma español, 45 en inglés) y un libro de neuroinmunología. Se utilizaron los términos de búsqueda COVID-19, coronavirus, SARS-CoV-2,manifestaciones neurológicas, sistema nervioso, patogénesis, según el descriptor de Ciencias de la Salud (DeCS). Análisis e integración de la información: El SARS-CoV-2 entra al sistema nervioso por la vía linfática, hematógena, transináptica retrógada, por diseminación local a través del etmoides o por disfunción de la barrera hematoencefálica. La patogenia puede ser por la acción directa del virus o inmunomediada. En la pandemia de COVID-19 se reportan pacientes con manifestaciones neurológicas centrales, periféricas y musculoesqueléticas. Los síntomas más frecuentes son los trastornos del gusto, el olfato, cefaleas, mialgias y mareos. En las formas graves se reportan meningitis, encefalitis, síndrome de Guillain-Barré, ictus y encefalopatías. Conclusiones: El SARS-CoV-2 puede afectar al sistema nervioso central y periférico. Causa principalmente manifestaciones leves y transitorias, aunque pueden ocurrir complicaciones neurológicas. Los mecanismos patogénicos principales son el daño citopático directo o mecanismos indirectos debido a una respuesta inflamatoria(AU)


Introduction: Coronaviruses infect humans and may cause neurological manifestations in susceptible individuals. Objective: Describe the pathogenesis of neurological manifestations in patients with COVID-19. Search strategy and selection criteria: A review was conducted of national and international updated bibliography. The search was carried out in Google Scholar and open access papers were consulted in the databases PubMed and SciELO from January 2014 to 6 May 2020. A total 51 papers (6 in Spanish and 45 in English) and a book on neuroimmunology were selected. The search terms used were COVID-19, coronavirus, SARS-CoV-2, neurological manifestations, nervous system and pathogenesis, in compliance with the Health Sciences Descriptors (DeCS). Data analysis and integration: SARS-CoV-2 enters the nervous system by lymphatic, hematogenous, transynaptic, retrograde routes, by local dissemination through the ethmoid, or by dysfunction of the hematoencephalic barrier. Pathogenesis may be due to direct action by the virus or immunomediated. During the COVID-19 pandemic patients have been reported with central, peripheral and musculoskeletal neurological manifestations. The most common symptoms are taste and smell disorders, headache, myalgia and dizziness. Meningitis, encephalitis, Guillain-Barré syndrome, stroke and encephalopathies have been reported in severe forms of the disease. Conclusions: SARS-CoV-2 may affect the central and the peripheral nervous system. It mainly causes mild, transient manifestations, but neurological complications may also occur. The main pathogenic mechanisms are direct cytophatic damage or indirect mechanisms resulting from an inflammatory response(AU)


Subject(s)
Humans , Virulence/immunology , Nervous System Diseases/complications , Coronavirus Infections/transmission
20.
Rev. Ciênc. Méd. Biol. (Impr.) ; 19(2): 342-346, set 24, 2020. fig, tab
Article in Portuguese | LILACS | ID: biblio-1358402

ABSTRACT

Introdução: a microbiota intestinal representa agrupamentos de micro-organismos encarregados de exercerem várias atividades indispensáveis para a regulação da homeostase. Esta, além da manutenção funcional do trato gastrointestinal (TGI), faz interferência na regulação do eixo de conexão entre o sistema nervoso entérico (SNE) com sistema nervoso central (SNC), denominado eixo intestino-cérebro, sendo uma comunicação bidirecional. Objetivo: identificar o papel da microbiota intestinal no processo de saúde e doença do hospedeiro humano, indispensável ao estudo de infecções e desordens do sistema nervoso entérico e sua relação com patologias neurológicas. Metodologia: foi realizado revisão integrativa da literatura nas bases de dados Scientific Eletronic Library Online (SciELO) e Literatura Latino Americana e do Caribe de Informação em Ciências da Saúde (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), além da Medical Publisher (PubMed). Resultados: constatou-se que a microbiota intestinal exerce influência sobre a cognição, o comportamento e também sobre o desenvolvimento neural. Além disso, a perda da homeostase do eixo intestino-cérebro pode contribuir para o surgimento de doenças mentais. Conclusão: através do estudo do eixo intestinocérebro, fica evidente a atuação da microbiota intestinal na manutenção da homeostase do SNC, bem como o seu envolvimento em várias disfunções, afetando o sistema nervoso e os intestinos, evidenciando uma via de comunicação bidirecional. Esse mecanismo é efetuado através de um sistema complexo de vias envolvendo os diversos componentes do sistema nervoso, endócrino e imunológico.


Introduction: the intestinal microbiota represents clusters of microorganisms that perform various activities that are essential for regulating homeostasis. This, in addition to the functional maintenance of the gastrointestinal tract (GIT), interferes in the regulation of the connection axis between the enteric nervous system (SNE) with the central nervous system (CNS), called the gut-brain axis, being a bidirectional communication. Objective: to identify the role of the intestinal microbiota in the health and disease process of the human host, indispensable for the study of infections and disorders of the enteric nervous system and its relation with neurological pathologies. Methodology: an integrative review of the literature was carried out in the Scientific Electronic Library Online (SciELO) and Latin American and Caribbean Literature on Health Sciences Information (LILACS), Medical Literature Analysis and Retrieval System Online (MEDLINE), as well as Medical Publisher (PubMed). Results: it was verified that the intestinal microbiota influences cognition, behavior and also neural development. In addition, the loss of intestinal-brain axis homeostasis may contribute to the onset of mental illness. Conclusion: through the study of the intestine-brain axis, the intestinal microbiota performance in the maintenance of CNS homeostasis is evident, as well as its involvement in various dysfunctions, affecting the nervous system and the intestines, evidencing a bidirectional communication pathway. This mechanism is effected through a complex system of pathways involving the various components of the nervous, endocrine and immune systems.


Subject(s)
Humans , Central Nervous System , Dysbiosis , Gastrointestinal Microbiome , Inflammation , Nervous System Diseases , Review , Database
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