RESUMO
During a twenty-year period 1967-1986, clinical features and clinical course of 50 patients with proved (in 3), clinically definite (in 32), early probable (in 13) and suspected (in 2) cases of multiple sclerosis were studied. Certain clinical characteristics in Thai patients are noteworthy, namely, a higher female to male ratio (4:1), a higher rate of optic nerve involvement (76%), and lower rate of brain stem involvement (30%) and cerebellar involvement (10%) during the course of illness in contrast to those of Western series. Painful tonic seizure was a prominent feature in Thai patients with multiple sclerosis (22/50 or 44%). Thirty out of 50 patients could be traced. Ten patients had died (33%) from the disease after 1-21 years with a mean of 8.08 years. Twenty patients (66%) were still alive. The follow-up period was 2-12 years with an average of 6.65 years. Among the twenty, 3 were bed-ridden, 3 were chair-bound and 5 had restricted activities. Nine patients (30%) were still working fully.
Assuntos
Atividades Cotidianas , Adolescente , Adulto , Fatores Etários , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Morbidade , Esclerose Múltipla/fisiopatologia , Fatores SexuaisRESUMO
The findings in this study suggest that there is defect in the neuromuscular transmission in hyperthyroidism. This abnormality was detected in 62 per cent of the patients and did not directly correlate with proximal muscle weakness present in most of the patients. It seems that the weakness in hyperthyroidism is the result of myopathy as well as neuromuscular transmission both of which might be due to the same metabolic derangement but are not directly related. After treatment, the muscle power became normal in all of the patients and the neuromuscular transmission was normalized in most but not all of them. It is possible that this transmission defect may be due to other mechanisms apart from the hormonal disorder e.g. the same processes as that which occurs in myasthenia gravis. The underlying pathophysiology is worth further exploration.