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Arq. neuropsiquiatr ; 76(3): 131-138, Mar. 2018. tab
Article Dans Anglais | LILACS | ID: biblio-888369

Résumé

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.


Sujets)
Humains , Mâle , Femelle , Adolescent , Adulte , Adulte d'âge moyen , Sujet âgé , Jeune adulte , Dégénérescences spinocérébelleuses/diagnostic , Dégénérescences spinocérébelleuses/épidémiologie , Maladies vestibulaires/diagnostic , Maladies vestibulaires/épidémiologie , Épreuves vestibulaires/méthodes , Brésil/épidémiologie , Troubles de la déglutition/physiopathologie , Troubles de la déglutition/épidémiologie , Dégénérescences spinocérébelleuses/physiopathologie , Dégénérescences spinocérébelleuses/génétique , Nystagmus pathologique/physiopathologie , Nystagmus pathologique/épidémiologie , Réaction de polymérisation en chaîne , Prévalence , Études transversales , Études rétrospectives , Répartition par sexe , Troubles neurologiques de la marche/physiopathologie , Troubles neurologiques de la marche/épidémiologie , Sensation vertigineuse/physiopathologie , Sensation vertigineuse/épidémiologie , Dysarthrie/physiopathologie , Dysarthrie/épidémiologie , Mutation
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