Critérios diagnósticos da esquistossomose mansônica meningomielorradicular

Valênça, Marcelo Moraes

doi:10.1590/s0004-282x2002000100043

Cited by 5 publications

(7 citation statements)

References 2 publications

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“…Literature data demonstrate that there is a clear predominance of schistosomiasis in men compared to women (Peregrino et al 1988, 2002, Brito et al 1992, Nobre et al 2001, Santos et al 2001. In the present study, among the patients with SMR, 66.2% were male.…”

Section: Discussionsupporting

confidence: 49%

“…However, this procedure carries a high risk of complications because it is invasive and may injure the nerve tissue even more. Therefore, it should be reserved for doubtful cases or those that do not respond to treatment (Peregrino et al 1988, 2002, Lambertucci et al 2005, 2007. In this context, it is important to comment on the necessity of identifying other laboratory evidence that, in association with the clinical and epidemiological findings, could corroborate the diagnosis of SMR.…”

Section: Discussionmentioning

confidence: 99%

“…Cases for which data were not available in the medical records (in spite of having fulfilled the diagnostic criteria established for this study) were also excluded. These criteria were followed with the aim of including as many cases as possible, taking into account possible, probable and proven cases of SMR as defined in the specialized literature (Ferrari 1997, Santos et al 2001, Valença 2002.…”

Section: Patients Materials and Methodsmentioning

confidence: 99%

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Clinical-epidemiologic profile of the schistosomal myeloradiculopathy in Pernambuco, Brazil

Araújo

Silva

Santos

et al. 2010

Mem. Inst. Oswaldo Cruz

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Section: Discussionsupporting

confidence: 49%

Section: Discussionmentioning

confidence: 99%

Section: Patients Materials and Methodsmentioning

confidence: 99%

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Clinical-epidemiologic profile of the schistosomal myeloradiculopathy in Pernambuco, Brazil

Araújo

Silva

Santos

et al. 2010

Mem. Inst. Oswaldo Cruz

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“…No mundo, estima-se ser a segunda doença parasitária de maior incidência, sendo sobrepujada apenas pela malária 3,4 . As formas de acometimento neurológico, na infestação pelo S. mansoni, são classificadas de maneira não uniforme na literatura [5][6][7] . Em diversos estudos foi adotada a classificação de Peregrino, cujas formas e freqüências são: mielorradiculítica (44%), mielítica (29,4%), pseudotumoral (24,7%), além da forma radiculítica pura e da síndro-me da artéria espinhal anterior, relatadas com menor freqüência na literatura 8 .…”

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Aspectos eletromiográficos preditores da evolução motora de pacientes com neuroesquistossomose

Correia

Júnior

Lins³

et al. 2007

Arq. Neuro-Psiquiatr.

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RESUMO -A neuroesquistossomose na forma mielorradicular é freqüentemente observada nos pacientes que residem no Nordeste do Brasil. Apesar disso, a evolução dos seus distúrbios neurológicos e padrões eletromiográficos são pouco estudados nesse grupo de pacientes. O objetivo deste estudo foi descrever e comparar a evolução motora com as anormalidades eletromiográficas de pacientes com neuroesquistossomose. Foram realizadas eletromiografias dos membros inferiores em 21 pacientes com diagnóstico presuntivo de radiculomielite esquistossomótica. O padrão eletromiográfico de 95,2% dos casos foi de multirradiculopatia axonal lombo-sacra, havendo extensão variável de desnervação, com predomínio de L 2 a S 2 . Foram identificados graus variáveis de paraparesia, havendo evolução motora mais favorável nos pacientes com envolvimento de menor número de raízes. A eletromiografia poderá fornecer dados prognósticos da evolução motora dos pacientes com radiculomielite esquistossomótica.PALAVRAS-CHAVE: neuroesquistossomose, eletromiografia, prognóstico. Electromyografic patterns predictive of motor evolution in neuroschistosomiasisABSTRACT -Neuroschistosomiasis in myeloradicular pattern is frequently observed in patients from Northeast of Brazil. Despite of this, the evolution of neurologic and electromyografic patterns is not well studied in this group of patients. The aims of this study were to describe and compare the clinic and electromyografic abnormalities of patients with neuroschistosomiasis and radicular involvement. We analyzed 21 electromyographic exams of the lower limbs carried out in the initial presentation of the disease. Electromyographic pattern of 95.2% of patients was compatible to axonal lombosacral multirradiculopathy, with variable denervation extension, but predominanthy from levels L 2 to S 2 . There was variable degree of deficit in the lower limbs, and the follow-up of motor disturbances was better more frequently when the roots were involved in smaller number. Electromyography should permit to know the motor prognosis of patients with myeloradiculitis due schistosomiasis.KEY WORDS: neuroschistosomiasis, electromyography, diagnosis. Do ponto de vista epidemiológico, a esquistossomose mansônica acomete cerca de 10% da população brasileira, estimando-se haver 17 milhões de esquistossomóticos no Brasil 1 . Segundo a Organização Mundial de Saúde, a maioria dos dados clínicos e laboratoriais, relativos ao Schistosoma mansoni, provêm do Brasil 2 . No mundo, estima-se ser a segunda doença parasitária de maior incidência, sendo sobrepujada apenas pela malária 3,4 . As formas de acometimento neurológico, na infestação pelo S. mansoni, são classificadas de maneira não uniforme na literatura [5][6][7] . Em diversos estudos foi adotada a classificação de Peregrino, cujas formas e freqüências são: mielorradiculítica (44%), mielítica (29,4%), pseudotumoral (24,7%), além da forma radiculítica pura e da síndro-me da artéria espinhal anterior, relatadas com menor freqüência na literatura 8 .O diagnóstico de certeza da n...

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“…Peregrino et al 8 reported that in 66.6% of their patients just the conus medullaris was involved, and no case of cervical involvement was described. Damage to the cervical segment has been described as very rare 12 , but Valença 13 reported its occurrence and concluded that it is imperative to examine all segments using MRI among SM patients.…”

Section: Discussionmentioning

confidence: 99%

Extensive spinal cord involvement in magnetic resonance imaging evaluation on schistosomal myelitis

Vidal¹,

Ferreira²,

Filho³

et al. 2012

Arq. Neuro-Psiquiatr.

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Schistosomiasis is a serious public health problem in some regions of the world. It is endemic in more than 74 countries and accounts for the majority of the cases of portal hypertension among the young population in these areas. Around the world, it is believed that there are about 200 million people infected by the Schistosoma species S. mansoni, S. haematobium, S. japonicum, S. intercalatum and S. mekongi 1,2 .The temporal clinical and systemic forms of the disease are: acute (toxemic and non-toxemic), latent and chronic 2,3 . The latter is divided into mild forms (intestinal and hepaticintestinal) and severe forms (hepatosplenic, pulmonary and glomerular) 2,3 .The presence and clinical significance of neurological lesions depend on the combination of the presence of eggs in the nervous system and the immune response of the host. In the majority of cases, a type IV or granulomatous delayed immune response occurs, and the response is greater in the earlier phases of schistosomiasis. In chronic forms, it becomes localized and attenuated (immunological modulation phenomenon) 4,5 . ABSTRACTThe diagnosis of schistosomal myelitis (SM) is frequently presumptive because no findings from any complementary examination are pathognomonic for this disease. The present report describes some abnormalities seen on magnetic resonance imaging (MRI) evaluation of a series of SM patients and discusses their etiopathogenesis. Methods: This study evaluated SM patients at the time of their diagnosis. These patients routinely underwent MRI on all segments of the spinal cord. Results: Thirteen patients were evaluated. The MRI was abnormal in 12 (92.3%) of them. In 11 patients (84.61%), the damage reached two or more spinal segments. Conclusions: MRI was an important diagnostic aid in this sample, because of the high rate of abnormalities detected. The tissue damage observed on MRI was extensive in the majority of the patients.Key words: Schistosoma mansoni, neuroschistosomiasis, myelitis, magnetic resonance imaging, diagnosis. RESUMOO diagnóstico da mielite esquistossomótica é frequentemente realizado por presunção, não havendo achado de exame complementar que seja patognomônico à condição. O presente estudo descreve alterações presentes na avaliação desses pacientes pela técnica da ressonân-cia magnética e discute sua etiopatogênese. Métodos: O estudo avaliou pacientes com mielite esquistossomótica no momento do diagnós-tico, os quais foram submetidos, rotineiramente, à ressonância magnética de todos os segmentos medulares. Resultados: Foram avaliados 13 pacientes, sendo a ressonância magnética alterada em 92.3% dos casos. Em 11 pacientes (84.61%), o dano abrangeu dois ou mais segmentos espinais. Conclusões: A ressonância magnética espinhal foi um importante auxílio diagnóstico nessa casuística em virtude da alta taxa de alterações detectadas. O dano tecidual observado foi extenso na maioria dos pacientes.Palavras-Chave: Schistosoma mansoni, neuroesquistossomose, mielite, imagem por ressonância magnética, diagnóstico.

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Critérios diagnósticos da esquistossomose mansônica meningomielorradicular

Cited by 5 publications

References 2 publications

Clinical-epidemiologic profile of the schistosomal myeloradiculopathy in Pernambuco, Brazil

Clinical-epidemiologic profile of the schistosomal myeloradiculopathy in Pernambuco, Brazil

Aspectos eletromiográficos preditores da evolução motora de pacientes com neuroesquistossomose

Extensive spinal cord involvement in magnetic resonance imaging evaluation on schistosomal myelitis

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