h i g h l i g h t s These guidelines provide orientation to perform clinical neurophysiological studies during COVID-19 pandemic. Guide to perform protective procedures for healthcare personal doing clinical neurophysiological studies. Offer a protocol for the disinfection of equipment and supplies in clinical neurophysiological studies.
-The chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an unusual but important complication of hematopoietic stem cell transplantation (HSCT) rarely reported to date. We describe a 17-year-old woman with a diagnosis of acute myeloid leukemia due to Fanconi's anemia who was submitted to allogeneic HSCT and developed CIDP as part of graft-versus-host disease. Investigation showed high cerebrospinal fluid protein; electrophysiological studies revealed sensory-motor demyelinating polyradiculoneuropathy; muscle and nerve biopsy were compatible with CIDP.KEY WORDS: graft-versus-host disease, hematopoietic stem cell transplant, bone marrow transplantation, neuropathy, polyneuropathy.polirradiculoneuropatia desmielinizante inflamatória crônica na doença do enxerto contra o hospedeiro após transplante de células hematopoiéticas alogênicas: relato de caso RESUMO -A polirradiculoneuropatia desmielinizante inflamatória crônica (CIDP) é uma incomum, porém, importante complicação do transplante de células hematopoiéticas (HSCT) raramente relatada até a data. Nós descrevemos uma mulher de 17 anos com diagnóstico de leucemia mielóide aguda por anemia de Fanconi que foi submetida à HSCT e desenvolveu CIDP como parte da doença do enxerto contra o hospedeiro. A investigação mostrou elevação na proteína no líquor; estudo eletrofisiológico revelando polirradiculoneuropatia desmielinizante sensitivo-motora; e biópsia de músculo e nervo compatível com CIDP. PALAVRAS-CHAVE: doença do enxerto contra o hospedeiro, transplante de células hematopoiéticas, transplante de medula óssea, neuropatia, polineuropatia.
Highlights
Identifying leprosy reactions is important to prevent disability.
HRUS with CD can be useful compared to NCS to diagnose acute inflammatory activity.
HRUS with CD helps reactions diagnosis in minimal and complete NCS abnormalities.
Different pathologies may be located at the petrous apex. The primary surgical approaches used to remove such lesions are the pterional, subtemporal, presigmoid, and retrosigmoid. Each has advantages and disadvantages, and the distance to the petrous apex varies with the approach. Anatomical variations in cranial morphology may interfere with these distances. Dolichocephalic skulls have a longer anteroposterior axis than brachycephalic ones.Three hundred computed tomographic scans and 65 dry human skulls were analyzed to determine if cranial morphology could indicate the shortest distance to the petrous apex. The distance between the external cortical table of the skull and the petrous apex in each surgical approach was measured. The lengths of the anteroposterior axis (L) and the widths of the lateral axis (W) were measured to determine the cranial index (W/L Â 100).This distance was longest in skulls with a high cranial index (brachycephalic) independent of the approach used. Statistical analysis showed that the distance to the previous apex was longest in the retrosigmoid approach and shortest in the pterional approach in all kinds of skulls. Brachycephalic skulls lose this ellipsoidal shape and the anterior laterolateral diameter is smaller than the posterior laterolateral diameter. Consequently, the distance from the cortical skull table to the petrous apex is shorter in brachycephalic skulls using all surgical approaches described in this article.
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