Síndrome de Brown-Séquard na esquistossomose: relato de caso

Reis, Fernanda Rodrigues dos; Brito, Jussara; Costa, Maria do Desterro Leiros da; Sousa, Aliane Barbosa Leal de; Queiroz, Ronaldo Bezerra de; Silva, José Alberto Gonçalves da

doi:10.1590/s0004-282x1993000200024

Cited by 3 publications

(2 citation statements)

References 12 publications

(2 reference statements)

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“…O cerebelo raramente é acometido 3 . A disseminação mielorradicular é mais freqüente 1,2,7,16,19,20,25,26 , provavelmente devida a fatores anatômicos 25,27,30 . As crianças são acometidas em uma proporção menor que os adultos 23,26 .…”

Section: Discussionunclassified

Esquistossomose cerebelar

Alves¹,

Almeida²,

Prandini³

2018

jbnc

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Os autores apresentam um caso de esquistossomose mansônica cerebelar, forma pseudotumoral, em paciente de 20 anos de idade e com manifestações clínicas determinadas pelo efeito compressivo da lesão granulomatosa: síndrome cerebelar e hidrocefalia obstrutiva. Tratado com derivação ventriculoperitoneal, exérese cirúrgica da lesão e oxamniquina 20 mg/kg, apresentou evolução favorável. A tomografia computadorizada realizada seis meses após o tratamento mostrou-se dentro dos padrões da normalidade. Ressalta-se a necessidade do diagnóstico diferencial, em regiões onde a esquistossomose é endêmica, já que esta neuroparasitose parece ser mais freqüente do que imaginamos.

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Section: Discussionunclassified

Esquistossomose cerebelar

Alves¹,

Almeida²,

Prandini³

2018

jbnc

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“…A TC realizada durante o internamento revelou imagem sugestiva de lesão expansiva. A hemissecção lateral da medula costuma associar-se a traumatismos, processos compressivos, hérnias de disco, infeccões, doenças desmielinizantes 27 e, em raras ocasiões, mielite esquistossomótica , fato relatado por Reis et al 28 .…”

Section: Métodounclassified

Mielopatias: considerações clínicas e aspectos etiológicos

Brito

Nóbrega

2003

Arq. Neuro-Psiquiatr.

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-We studied 97 inpatients with myelopathy at the University Hospital Lauro Wanderley from 1985 to 2002. Ages ranged from 10 to 78 years and average age was 39.8 years. All patients were examined by neurologist. Cerebrospinal fluid (CSF) was analysed in 44 (45.3%) cases and immunofluorescence reactions and/or ELISA in CSF were made in 32 (32.9%) cases. Radiologic investigation of the vertebral spine and spinal cord of the 32 (32.9%) cases consisted of 8 radiographies, 10 computed tomography and 14 magnetic resonance image. In 41 (42.2%) cases the lesions were situated in the lower dorsal and lumbar level and complete transverse lesion were registred in 61 (62.8%) cases. There was predominance of transverse myelitis (43.2%) and spinal cord compression (15.46%). Spinal cord schistosomiasis was the form more often of the transverse myelitis (13.4%).

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Spinal Cord Schistosomiasis: A Report of 2 Cases and Review Emphasizing Clinical Aspects

Ferrari

1999

Medicine

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Schistosomal myeloradiculopathy (SMR) is a severe and little known form of presentation of schistosomiasis mansoni and hematobic schistosomiasis. The literature concerning the entity is scarce, and most publications are limited to isolated case reports. Thus, to consolidate and analyze the knowledge currently available about the disease, I reviewed 231 cases, with emphasis on clinical aspects. Although variations occur, in most cases the clinical picture of SMR is highly suggestive in individuals with epidemiologic antecedents of the infection. Thus, a patient with SMR is usually a young male with no other manifestations of schistosomal infection who presents with lumbar pain, often of a radicular nature, soon followed by weakness and sensory loss of rapid progression in the lower limbs associated with autonomic dysfunction, particularly bladder dysfunction. The most suggestive elements of the entity, and therefore of higher diagnostic value, are the low localization of the spinal cord lesion, the acute or subacute onset of the disease, and the association of manifestations due to medullary and radicular involvement. SMR is commonly classified into clinical or anatomoclinical forms. However, I observed no consensus in this classification even in terms of the terminology used. The analysis performed in this review permitted the introduction of a new concept not yet reported in the literature regarding the possibility that the disease consists of a continuous spectrum, with asymptomatic egg laying in the spinal cord at 1 end of the spectrum and devastating forms at the other end, with most cases occupying an intermediate position and with the various types of damage overlapping and associated to different degrees. This concept applies not only to different patients but also to the same patient at different stages of the disease. Chemical and cytomorphologic examination of cerebrospinal fluid (CSF) almost always revealed mildly or moderately increased total protein concentration and predominantly lymphocytic pleocytosis. Eosinophils, the least nonspecific finding, were detected in the CSF of less than half (40.8%) the patients. Myelography and computed tomography-myelography were altered in 63.3% of cases, but this proportion may be an overestimate. The most frequent changes were images of a filling defect due to expansion of the spinal cord and were almost always demonstrated by the 2 imaging modalities. Although still few in number, early reports suggest that magnetic resonance imaging is more sensitive; however, the changes are also nonspecific, such as those revealed by myelography and computed tomography-myelography. Parasite eggs were demonstrated frequently in a biologic specimen (88.3%), but difficulty in detection was not uncommon. Peripheral blood eosinophilia was detected in 64.5% of patients and represented a nonspecific finding. The detection of anti-Schistosoma antibodies in the serum or CSF was also frequent (94.9% and 84.8%, respectively). The presence of anti-Schistosoma antibodies in serum is of li...

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Síndrome de Brown-Séquard na esquistossomose: relato de caso

Cited by 3 publications

References 12 publications

Esquistossomose cerebelar

Esquistossomose cerebelar

Mielopatias: considerações clínicas e aspectos etiológicos

Spinal Cord Schistosomiasis: A Report of 2 Cases and Review Emphasizing Clinical Aspects

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