Miositis por cuerpos de inclusion: comunicacion de cuatro casos / Inclusion body myositis. Report of 4 cases

Inclusion body myositis (IBM) is a primary inflammatory myopathy characterized by an older age at presentation. We describe four IBM cases fulfilling Mendell's diagnostic criteria. All patients were older than 60 years at diagnosis and the mean length of time from onset to diagnosis was 5.7 years. Two of them complained of leg weakness with unsteady gait and the other two, of upper limb weakness. Three patients had dysphagia, one of them had diaphragmatic paralysis and another had bilateral blepharoptosis. Histological sections of the muscle biopsy showed mononuclear cell invasion of nonnecrotic muscle fibers, rimmed vacuoles, intracellular amyloid deposits and 16-21 nm tubulofilaments by electron microscopy. Mitochondrial anomalies were found in two cases. Only one patient had transient response to steroid therapy. Our serie shows that clinical presentation of inclusion body myositis includes a broader spectrum than the classical description.

Infarto de la arteria cerebelosa antero inferior (AICA) como causa de sindrome vestibular agudo / Infarction in the antero inferior cerebellar artery (AICA)

Los ataques de vértigo de corta duración pueden ser de etiología vascular. El vértigo puede ocurrir acompa±ado de síntomas de tronco cerebral o cerebeloso, o puede producirse aisladamente. Aqui reportamos el caso de una mujer de 78 a±os de eda, hipertensa que comienza con vértigo agudo e hipoacusia en iodo derecho, sugestivo de disfunción véstibular periférica. La RNM de cerebro muestra una lesión isquémica en el péndiulo cerebeloso medio derecho, en el territorio de la arteria cerebelosa antero inferior. Concluimos que la combinación de s´ntomas vestibulares periférico y centrales provee la clave diagnóstica en el infarto de arteria cerebelosa antero inferior. (AICA: Antero Inferior Cerebellar Artery)ASTRACTS: Vertigo attacks af short duration may be of vascular etiology. This kind of vertigo may occur along with symptoms of brainstem or cerebellar dysfuntion or can be isolated. We report a 78 year old hypertensive woman, with the sudden onset of vertigo and right ear deafness, suggesting peripheral vestibulat disease. An MRI study disclosed and ischemic lesion in the right middle cerebellar peduncle, in the territory of the antero inferior cereballar artery (AICA). We conclude that a combination or peripheral and central vestibular symptoms provides the diagnostic clue to AICA infarction