Otoneurological findings prevalent in hereditary ataxias / Alterações otoneurológicas prevalentes nas ataxias hereditárias

ABSTRACT Objective To describe and compare the vestibular findings most evident among the hereditary ataxias, as well as correlate their clinical features with the nervous structures affected in this disease. Methods Seventy-five patients were evaluated and underwent a case history, otorhinolaryngological and vestibular assessments. Results Clinically, the patients commonly had symptoms of gait disturbances (67.1%), dizziness (47.3%), dysarthria (46%) and dysphagia (36.8%). In vestibular testing, alterations were predominantly evident in caloric testing (79%), testing for saccadic dysmetria (51%) and rotational chair testing (47%). The presence of alterations occurred in 87% of these patients. A majority of the alterations were from central vestibular dysfunction (69.3%). Conclusion This underscores the importance of the contribution of topodiagnostic labyrinthine evaluations for neurodegenerative diseases as, in most cases, the initial symptoms are otoneurological; and these evaluations should also be included in the selection of procedures to be performed in clinical and therapeutic monitoring.

RESUMO Objetivo Descrever e comparar os achados vestibulares mais evidentes entre a ataxia hereditária, bem como correlacionar seus aspectos clínicos com o estudo das estruturas nervosas afetadas nesta doença. Métodos 75 pacientes foram avaliados e submetidos aos seguintes procedimentos: anamnese, avaliação otorrinolaringológica e vestibular. Resultados Clinicamente, os pacientes apresentaram sintomas de distúrbios da marcha (67,1%), tonturas (47,3%), disartria (46%) e disfagia (36,8%). No teste vestibular, as alterações foram predominantemente evidentes no teste calórico (79%), dismetria sacádicas (51%) e no teste rotatório (47%). A presença de alterações ocorreu em 87% dos pacientes. A maioria das alterações observadas foram da disfunção vestibular central (69,3%). Conclusão O estudo ressalta a importância da contribuição da avaliação labiríntica no topodiagnóstico para doenças neurodegenerativas, uma vez que, na maioria dos casos, os sintomas iniciais são otoneurológicos, e essas avaliações também devem ser incluídas na seleção de procedimentos a serem realizados no monitoramento clínico e terapêutico.

Foot drop in under training soldiers: report of 42 cases referred to Be'sat hospital between 2003-2000

Foot drop is a state that patient is unable to do dorsiflexion or extension of foot fingers. External pressure is the most important cause of this neuropathy. Among soldiers, following the heavy training, this complication may occur that cause frequent reference of soldiers to military hospitals wasting human force and economic load. Therefore, we decided to evaluate frequency of this disease and find methods to prevent. This study is a descriptive case series that was performed by studing hospital files of 42 patients during the years 2000 to 2003 and the data was analyzed by SPSS-11.5 sofware. Twenty-eight [66.66%] patients had training for one month, 12 patients had [28.57%] between 1-3 month and 2 patients had [4.77%] longer of 3 month. Six cases [14.29%] had complete injury and 36 cases had incomplete injury. Seven cases [16.67%] had complete recovery and 35 cases [83.33%] had incomplete injury and none had paralysis. Changes in NCV was detected but EMG was normal. Trauma following to military training probably due to squatting leads to foot drop