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Daniela Oliveira de Andrade
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ABSTRACT: This study investigated 54 patients with cervical spondylosis (CS) with or without symptoms caused by cervical spondylotic myelopathy. Cervical MRI, somatosensory evoked potentials (SEPs) and motor evoked potentials (MEP) from upper and lower limbs of all of these patients were examined retrospectively. Were MRI findings the gold standard and the patients were classified in three groups. Group 1 (absence of spinal cord compression); Group 2 (presence of spinal cord indentation); Group 3 (spinal cord compression with alteration of intraspinal sign). The sensitivity of SEP of four limbs was 61.9%, the same one as the SEP of lower limbs. The sensitivity of MEP of four limbs was 71.4%, of the upper limbs alone was 66.7% and of the lower limbs alone 52.4%, thus showing the importance of using this method in all four limbs when cervical spondylotic myelopathy is suspected. The results shown by the study of the tibial nerve in SEP and of the abductor digiti minimi muscle in MEP were more frequently abnormals than the results shown by the study of the median nerve and extensor digitorum brevis muscle in the three groups, suggesting that exists a onset compromising of them.
Arquivos de Neuro-Psiquiatria 10/2005; 63(3B):843-6. · 0.72 Impact Factor
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Daniela Oliveira de Andrade
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ABSTRACT: This study investigated 63 patients with HTLV-I associated myelopathy/tropical spastic paraparesis (HAM/TSP) by somatosensitive evoked potentials (SEPs) and 42 of them by motor evoked potentials (MEP). All the patients had typical clinical history of HAM, serum samples tested positive for antibodies to HTLV-I screened for Particle Agglutination, ELISA and complemented by Western blot test. In patients studied by SEPs of lower limbs 51/63 (81 %) were abnormal and 11 of them (17.5%) were abnormal in upper limbs also. In patients studied by MEP 37/42 were abnormal, 34/42 (81%) in lower limbs and 25/42 (59.5%) in upper limbs. A high percent of the population studied had abnormalities of the corticospinal tracts on the four limbs at the PEM, without abnormalities in upper limbs by SEPs, showing the correlation between central motor conduction time in upper limbs and the clinical severity of HAM/TSP (p < 0.01). It was not found correlation between time of disease and the results of the SEPs and MEP (p = 0.69).
Arquivos de Neuro-Psiquiatria 09/2005; 63(3A):652-5. · 0.72 Impact Factor
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Daniela Oliveira de Andrade
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ABSTRACT: There are few reports of the ictal pattern of benign partial epilepsy with centrotemporal Spikes (BECTS) in the literature. This paper describes the case of a 7-year-old boy without significant perinatal history or psychomotor development delay. There was positive family history of seizures. Magnetic resonance imaging scans of the head was normal. The patient had a nocturnal isolated seizure, followed by a postictal motor deficit at the left arm. The EEG two days after the seizure showed a normal background activity with spikes in the centrotemporal bilateral area, and two subclinicals rhythmic discharges of spike and wave, with a duration of more than 50 seconds in the right centrotemporal area. This pattern of rhythmic discharge wasn not described in BECTS before.
Arquivos de Neuro-Psiquiatria 07/2005; 63(2A):360-3. · 0.72 Impact Factor
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ABSTRACT: The neurocutaneous melanosis (NCM) is a rare, neuroectodermal dysplasia defined by the association of giant or multiple, nonmalignant pigmented cutaneous nevi with leptomeningeal melanosis or melanoma. As a rule, the cerebral pathological substratum is characterized by a melanocytic infiltration of the leptomeninges, often leading to hydrocephalus. The most frequent clinical symptomatology starts early in life, with convulsive seizures, psychomotor delay, intracranial hyperpression: the prognosis is severe. Malignant melanomas can also occur. One 21 years-old patient affected by NCM with a giant bathing nevus and epilepsy is reported. Her psychomotor development was slightly delayed. Academic progress was disturbed by the frequency of seizures and the multiple dermatological surgeries, and she remained at the elementary school level. Her epilepsy appeared at seven years and became pharmacoresistant. It was a focal, left temporal epilepsy. Neuroimaging investigations were performed repeatedly, and demonstrated the progressive appearance of parenchymal lesions with T1 and T2 shortening, without contrast enhancement, at the pons (11 years), the two hippocampi (14 years), and of an atrophy of the cerebellum and the brainstem (19 years). No hydrocephalus, tumoral aspect, or meningeal involvement were demonstrated. This patient's case is peculiar because her neurological symptomatology consists only of focal epilepsy, unrelated to a tumor, with moderate cognitive impairment despite a rather long course of the disease. Her evolution raises the question of condidency to surgical treatment.
Epileptic disorders: international epilepsy journal with videotape 10/2004; 6(3):145-52. · 1.50 Impact Factor
