Migraine Headache in Patients with Sydenham's Chorea (original) (raw)
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Síndrome das Pernas Inquietas: Revisão e Atualização
2009
A Síndrome das Pernas Inquietas (SPI) é um distúrbio sensório-motor que causa grande desconforto em seus portadores, e ainda é pouco conhecido pela população e por profissionais da área médica. Pela falta de conhecimentos, muitos pacientes recebem diagnóstico errado e tratamento inadequado. Recentemente, os componentes genéticos da SPI têm sido mais estudados e compreendidos, o que pode melhorar o entendimento da fisiopatologia desta doença. O objetivo deste estudo é apresentar uma revisão e atualização sobre os conhecimentos a respeito da SPI, incluindo métodos diagnósticos mais empregados e as opões de tratamento, buscando sempre a melhor evidência científica para cada situação.
Movement disorders of probable infectious origin
Annals of Indian Academy of Neurology, 2014
as HIV [4] have been reported causing whole range of MDs. Kalita and Misra [8] in their study on Japanese encephalitis had reported predominant post-encephalitic dystonia. Isolated case reports of infl uenza virus encephalitis causing chorea and paroxysmal dyskinesias have also been reported. [6,9] Bacterial infections such as streptococcal group causing Sydenham's chorea have been most widely proven. Though the incidence of Sydenham's chorea has reduced it is still prevalent in developing countries. Parasitic infections such as toxoplasma abscesses in the subthalamic nucleus, thalamus, caudate nucleus, or globus pallidus have been reported to be associated with contralateral limb ballism, choreoathetosis, and dystonia. [3] Several studies have a empted to explain the MDs secondary to specifi c infectious agent. Apart from a large study on SMD [2] conducted at our center, most of the reports are limited to a single patient or a series of patients defi ning a particular infectious agent. The conclusions from these studies are varied and diffi cult to generalize. The objectives of our study were to 1. Characterize the pattern (phenomenology) of MD temporarily related to infection 2. Characterize the probable nature of infection causing SMD, and
Neuropsychiatric manifestations of Sydenham's chorea: a systematic review
Developmental medicine and child neurology, 2015
Sydenham's chorea is a post-streptococcal, autoimmune, neuropsychiatric movement disorder. Sydenham's chorea is a major criterion for diagnosis of acute rheumatic fever with the implication of potential long-term sequelae including cardiac complications. It is well established that there is psychiatric comorbidity in Sydenham's chorea, but there are variations in the literature regarding the nature and prevalence of psychiatric diagnoses associated with Sydenham's chorea. The aim of this review was to systematically evaluate the evidence for psychiatric symptoms presenting with Sydenham's chorea. Knowledge of comorbid psychiatric symptomatology will support early diagnosis and treatment, leading to improved long-term outcomes for children with Sydenham's chorea. The study used a systematic search strategy, using MEDLINE, MEDLINE in Process, EMBASE, and The Cochrane Library. Abstracts were screened to identify relevant papers which were then assessed further. ...
Revista Brasileira de Reumatologia, 2009
Introduction: Lyme disease (LD) is a tick-borne disease, caused by Borrelia burgdorferi sensu lato spirochetes, transmitted by Ixodes ricinus complex ticks, which leads to multiple systemic clinical manifestations. In Brazil, a different syndrome is described that mimics LD symptoms, but that also manifests high frequencies of recurrent episodes and immune-allergic manifestations. It is transmitted by the Amblyomma cajennense tick and the etiological agent is an uncultivable spirochete with atypical morphology. Due to its particularities, this emerging zoonosis has been called Brazilian LD-like syndrome or Baggio-Yoshinari Syndrome (BYS). Objective: To describe the neurological spectrum of BYS. Patients: Thirty patients with neurological symptoms of BYS were analyzed. Results: Mean age of patients was 34.2 ± 13.3 years old (6 to 63 years); 20 were females and 10 males. A high number of recurrent episodes (73.6%) and severe psychiatric or psycho-social disturbances (20%) were distinguishing features. Erythema migrans similar to those seen in the Northern hemisphere was identified in 43.3% of patients at disease onset. The recurrence of skin lesions diminished as the disease progressed. Articular symptoms (arthritis) happened in nearly half of patients at BYS onset and during relapsing episodes. Conclusions: The BYS is considered a new tick borne disease in Brazil that differs from classical LD observed in the Northern hemisphere. BYS replicates most of the neurological symptoms observed in LD, except for the additional presence of relapsing episodes and the tendency to cause chronic neurological and articular manifestations.
Trindade_et_al-2016-Acta_Neurologica_Scandinavica.pdf
Objective -To determine characteristics, clinical significance, frequency, and mimics of restless legs syndrome (RLS) in a cohort of Wilson's disease (WD, n = 42/f = 18), compared to healthy, matched controls. Materials and methods -Structured clinical interviews (patients and caregiving family members), repeated neurological examinations (afternoon and presleep), comprehensive laboratory tests, WD-, RLS-, and sleep-specific rating scales, and videopolysomnography. Results -Thirteen patients with WD (13/ 42 = 31.0%) clearly fulfilled the five diagnostic criteria of RLS; in eight patients (19.1%), the burden of RLS was clinically significant. The RLS was of moderate severity, equally distributed among sexes, manifested mainly in the evening and before falling asleep, and had developed mostly after clinical manifestation of WD (time elapsed 10.2 AE 14.5 years), still at a young mean age (27.5 AE 11.5 years). The known RLS-associated features were absent (normal iron and kidney parameters) or rare (positive family history, polyneuropathy). Compared to WD patients without RLS, patients with RLS were significantly elder and had suffered longer from WD. WD-specific RLS mimics as well as RLS confounding motor comorbidities (dystonia, tremor, chorea) were frequent and a diagnostic challenge; in difficult cases, the differentiation was reached by clinical observation of the motor behavior in the evening or at nighttime. Conclusion -RLS was frequent in this cohort of WD and might be causally related to WD. RLS should be included in the diagnostic work-up of WD. In complex motor disorders, differential diagnosis of RLS might require evening/nighttime examination and videopolysomnography. In WD patients with a clinically significant RLS, treatment with dopaminergic substances may be considered.
Clinical Neurophysiology, 2003
Introduction: Hopkins syndrome is motor neuron disease that leads to a flaccid paralysis affecting one or more limbs resembling poliomyelitis. It follows an asthmatic attack and the prognosis is poor. All the 33 related cases occurred after 13 months of age and there is no report in Latin America. Our objective is to describe a case of Hopkins Syndrome in Brazil affecting a patient younger than 1 year. Case report: Male 3-month-old infant, started presenting wheezing that turned into respiratory failure which required mechanical ventilation. Three days later he initiated with loss of strength in the lower limbs (LL). The patient was dismissed from hospital the better for his respiratory complaints but still paraparetic. Six months later, the patient returned with another episode of severe bronchospasm. At that time, he presented with flaccid paralysis, areflexia and atrophy of the LL. There were no upper limbs and sensory abnormalities. The patient underwent lumbar puncture, spinal MRI and SEPs that were all normal. EMG and NCS were in keeping with motor neuron disease affecting just the lumbosacral region. Conclusion: Hopkins syndrome should be included in the differential diagnosis of any flaccid paralysis when it is associated with an asthma attack. 2 A review of the electromyographic criteria in sexual performance-P.
Sydenham chorea: clinical, EEG, MRI and SPELT findings in the early stage of the disease
Journal of Neurology, 1993
An 18-year-old man suffered from acute Sydenham chorea appearing coincidently with β-haemolytic streptococcal throat infection. Imaging techniques documented lesions of basal ganglia and substantia nigra. In the early course of the disease vascular lesions may be important pathogenetic mechanisms of this acquired movement disorder.
Etiology of parkinsonism in a Brazilian movement disorders clinic
Arquivos de Neuro-Psiquiatria, 1998
Objective: The aim of the present study is to investigate whether there are geographic differences in the etiology of parkinsonism (PA). Background: 72% of patients with PA evaluated at movement disorders clinics in the Northern Hemisphere are diagnosed with Parkinson's disease (PD). Data regarding other regions are not available. Methods: We reviewed the charts of all patients with PA seen at the Federal University of Minas Gerais Movement Disorders Clinic from July 1993 through October 1995. PA was diagnosed by the presence of at least two of the following: rest tremor, bradykinesia, rigidity, and postural instability. The different etiologies were diagnosed based on standard clinical criteria Results: During the period of the study, PA was recognized in 338 subjects. The following clinical diagnoses were made: PD (68.9%), drug-induced PA (DIP) (13.3%), vascular PA (4.7%), Progressive supranuclear palsy (PSP) (2%), multiple system atrophy (MSA) (1.8%), others (9.7%). Cinnarizine, haloperidol and flunarizine were the commonest drugs related to DIP. Conclusions: Similarly to other studies, PD accounts for about 70% of PA patients. However, there are differences between our results and previous series. DIP is much more common in the present series. This may be accounted for a more liberal use of antidopaminergic drugs in our environment, especially Calcium channel blockers. The lower frequency of MSA and PSP in our study may reflect a short follow-up, since many patients initially diagnosed with PD later are found to have Parkinson-plus syndromes.