ABSTRACT
Multiple system atrophy (MSA) is a sporadic, neurodegenerative disorder, clinically characterized by parkinsonian, autonomic, cerebellar and pyramidal signs. We describe two patients showing different presentations of the same disease. The patient on case 1 presents features of MSA-C or olivopontocerebellar atrophy with the pontine "cross sign" on brain MRI. The second case reports a patient presenting MSA-P or striatonigral degeneration and the brain MRI shows lenticular nucleus sign alteration. We think that brain MRI might increase the accuracy diagnostic of MSA.
Subject(s)
Brain/pathology , Olivopontocerebellar Atrophies/pathology , Striatonigral Degeneration/pathology , Female , Humans , Magnetic Resonance Imaging , Male , Middle AgedABSTRACT
Multiple system atrophy (MSA) is a sporadic, neurodegenerative disorder, clinically characterized by parkinsonian, autonomic, cerebellar and pyramidal signs. We describe two patients showing different presentations of the same disease. The patient on case 1 presents features of MSA-C or olivopontocerebellar atrophy with the pontine "cross sign" on brain MRI. The second case reports a patient presenting MSA-P or striatonigral degeneration and the brain MRI shows lenticular nucleus sign alteration. We think that brain MRI might increase the accuracy diagnostic of MSA.
A atrofia de múltiplos sistemas (AMS) é uma doença neurodegenerativa esporádica caracterizada clinicamente por diferentes combinações de sinais parkinsonianos, autonômicos, cerebelares e piramidais. Descrevemos dois pacientes apresentando diferentes formas clínicas da mesma afecção. O caso 1 tem características da AMS-C ou atrofia olivopontocerebelar, apresentando na ressonância magnética (RM) o "sinal da cruz" na ponte. Já o caso 2 tem AMS-P ou degeneração nigro-estriatal, a RM mostra alteração do sinal no núcleo lentiforme entre outras alterações. Acreditamos que a RM cerebral possa contribuir para o melhor diagnóstico da AMS.
Subject(s)
Female , Humans , Male , Middle Aged , Brain/pathology , Olivopontocerebellar Atrophies/pathology , Striatonigral Degeneration/pathology , Magnetic Resonance ImagingABSTRACT
The Guilllain-Barré syndrome (GBS) is an acute predominantly demyelinating polyneuropathy. In many cases GBS is preceding by infection, immunization, surgery or trauma. Although there are a few reports of GBS after head trauma, there is no report of this syndrome after brachial plexus injury. We report on a 51 years-old man who presented GBS fifteen days after a brachial plexus trauma. The polineuropathy resolved completely in a few weeks. We believe that GBS was triggered by the trauma that evoked an immune mediated disorder producing inflammation and demyelination of the peripheral nerves.
A síndrome de Guillain-Barré (SGB) é uma polineuropatia predominantemente desmielinizante, que ocorre na maioria das vezes após uma infecção, vacinação, cirurgia ou traumatismo. Embora tenham sido descritos alguns casos após traumatismo crânio encefálico, ainda não foi referido caso de SGB após traumatismo do plexo braquial. Relatamos o caso de um homem de 51 anos que 15 dias após ter apresentado paralisia traumática do plexo braquial, desenvolveu SGB. Recuperou-se inteiramente em algumas semanas. Achamos que em nosso caso a SGB foi desencadeada pelo traumatismo, que provocou distúrbios imunológicos com conseqüente acometimento dos nervos periféricos.
Subject(s)
Humans , Male , Middle Aged , Brachial Plexus/injuries , Guillain-Barre Syndrome/etiology , Guillain-Barre Syndrome/drug therapy , Immunoglobulins, Intravenous/therapeutic use , Treatment OutcomeABSTRACT
The Guilllain-Barré syndrome (GBS) is an acute predominantly demyelinating polyneuropathy. In many cases GBS is preceding by infection, immunization, surgery or trauma. Although there are a few reports of GBS after head trauma, there is no report of this syndrome after brachial plexus injury. We report on a 51 years-old man who presented GBS fifteen days after a brachial plexus trauma. The polineuropathy resolved completely in a few weeks. We believe that GBS was triggered by the trauma that evoked an immune mediated disorder producing inflammation and demyelination of the peripheral nerves.