A.C.A.F. Ferreira

No evidence of disease activity in multiple sclerosis patients

ABSTRACT Introduction: Multiple Sclerosis is a chronic inflammatory demyelinating disease that affects 2.5 million people in the world. NEDA (No evidence of disease Activity) −4 is a new concept related to absence of disease activity in the context of MS. It takes into account the following four parameters: relapses; disability progression; lesion load and brain atrophy. Areas covered: The purpose of this paper is to visit the new emerging concepts of NEDA. Although it is considered important and attractive, there is a lack of uniformity. Expert commentary: Although NEDA-4 embraces important markers of disease activity and degeneration, this definition is still evolving and other parameters apart from the loss of brain volume might be included, especially those related to disability, such as cognitive problems, visual function, fatigue and pain.

Zika Virus Infection in the Elderly: Possible Relationship with Guillain-Barré Syndrome

The Zika virus (ZIKV) outbreak in French Polynesia, in 2013, and in Brazil, in 2015, was correlated with neurological complications, which comprised, among others, congenital microcephaly and Guillain-Barré syndrome (GBS), which includes a group of acute autoimmune neuropathies generally reported after respiratory or gastrointestinal infectious diseases. Despite being relatively rare, the incidence rate of GBS rises with age, which makes GBS more frequent in the elderly, in whom it is also a more severe disease with slower recovery than in younger patients. Different forms of GBS have been described having diagnostic confirmation of a previous infection with the ZIKV virus. Although we do not have enough evidence that elderly people are a particularly susceptible population to developing GBS following ZIKV infection, this is plausible. We should consider this possibility, particularly taking into account that aging subjects are more susceptible to infections. In this context, a deeper understanding of how the immune system in the elderly functions in relation to ZIKV infection is necessary, as well as an understanding of what kind of alterations of the nervous system such an infection triggers in the elderly, beyond GBS. This will be relevant for better therapeutic interventions and for designing vaccine candidates that can be applied in an aging population, particularly those prone to develop ZIKV-induced autoimmunity.

Frontotemporal dementia in amyotrophic lateral sclerosis: from rarity to reality?

Marco Orsini,1 Ana Carolina Andorinho de Freitas Ferreira,2 Osvaldo J.M. Nascimento,2 Jano Alves de Souza,2 Thaís Nascimento Magalhães,2 Anna Carolina Damm de Assis,2 Larissa Kozow Westin,2 Bruno Pessoa,2 Acary Bulle Oliveira,3 Rossano Fiorelli,4 Marcos R.G. de Freitas,2 Juliana Bittencourt,1 Stenio Fiorelli,4 Maria Fernanda Freitas Ferreira Moreira,5 Pedro Ribeiro1 1Brain Mapping Laboratory and Electroencephalogram, Federal University of Rio de Janeiro and Severino Sombra University Center, Vassouras, RJ; 2Antonio Pedro University Hospital – HUAP – Federal Fluminense University, Niterói; 3Department of Neurology, Federal University of São Paulo;. 4Department of Neurology, Masters Program (Neurology) – UNIRIO; 5Estácio de Sá University, School of Medicine, Rio de Janeiro, Brazil

Cognitive impairment in neuromuscular diseases: A systematic review

Neuromuscular diseases are multifactorial pathologies characterized by extensive muscle fiber damage that leads to the activation of satellite cells and to the exhaustion of their pool, with consequent impairment of neurobiological aspects, such as cognition and motor control. To review the knowledge and obtain a broad view of the cognitive impairment on Neuromuscular Diseases. Cognitive impairment in neuromuscular disease was explored; a literature search up to October 2017 was conducted, including experimental studies, case reports and reviews written in English. Keywords included Cognitive Impairment, Neuromuscular Diseases, Motor Neuron Diseases, Dystrophinopathies and Mitochondrial Disorders. Several cognitive evaluation scales, neuroimaging scans, genetic analysis and laboratory applications in neuromuscular diseases, especially when it comes to the Motor Neuron Diseases, Dystrophinopathies and Mitochondrial Disorders. In addition, organisms model using rats in the genetic analysis and laboratory applications to verify the cognitive and neuromuscular impacts. Several studies indicate that congenital molecular alterations in neuromuscular diseases promote cognitive dysfunctions. Understanding these mechanisms may in the future guide the proper management of the patient, evaluation, establishment of prognosis, choice of treatment and development of innovative interventions such as gene therapy.

Anti-musk positive myasthenia gravis and three semiological cardinal signs

Myasthenia gravis (MG) is a relatively uncommon disorder with an annual incidence of approximately 7 to 9 new cases per million. The prevalence is about 70 to 165 per million. The prevalence of the disease has been increasing over the past five decades. This is thought to be due to better recognition of the condition, aging of the population, and the longer life span of affected patients. MG causes weakness, predominantly in bulbar, facial, and extra-ocular muscles, often fluctuating over minutes to weeks, in the absence of wasting, sensory loss, or reflex changes. The picture of fluctuating, asymmetric external ophthalmoplegia with ptosis and weak eye closure is virtually diagnostic of myasthenia. We report an atypical MG case with three semiological cardinal signs.

Currents issues in cardiorespiratory care of patients with post-polio syndrome

METHOD A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles) were considered. RESULTS AND DISCUSSION Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. CONCLUSION Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.

Age of independent sitting posture acquisition for children with myelomeningocele

Objective: To study the acquisition of independent sitting posture in patients with high lumbar and thoracic myelomeningocele (MMC). Method: Cross-sectional study in children aged between 6 months and 4 years with MMC. A research was done in medical records and report cards from children being followed in the physical therapy sector at Fernandes Figueira Institute (IFF), Rio de Janeiro, RJ, Brazil. Results: The sample comprised 16 children with MMC, 9 (56%) female and 7 (43%) male, 13 (81.2%) children with high lumbar level, and 3 (18.8%) with thoracic level. In relation to independent sitting posture, 13 (81.2%) achieved this objective. The average time to reach this posture was 16 months (9-31). The average time of physiotherapeutic following was 3 months (1-8). Among the 13 children who sat, 2 (15.4%) were thoracic and 11 (84.6%) high lumbar level cases. Most (15 – 93.8%) performed regular physical therapy. The average age to start treatment was 3 months (1-8). Conclusion: It was observed that the largest part of the sample acquired independent sitting posture, including the thoracic level cases that reached this goal in a younger age than the found in the literature. The results can be considered positive, reinforcing the early physiotherapeutic intervention for the acquisition of motor development, promotion of functionality, and improvement of quality of life of children with MMC.

Following the Natural History of A Probable Adrenoleukodystrophy Case and Literature Review

Leukodystrophies compass a wide range of genetic disorders that compromise the white matter. Some of them exhibit different phenotypes with late and slow onset. The present work reports an unusual case of probable X-Linked Adrenoleukodystrophy that could be classified in adrenomyeloneupathy, but there were no signs of adrenal insufficiency and the cognitive decline developed fast. MRI evinced classical symmetrical parieto-occipital pattern of lesion, although dosage of very long chain fatty acids was normal. *Corresponding author: Orsini, M. Masters Program in Science Rehabitation, UNISUAM, Neuroscience Department, Bonsucesso, Rio de Janeiro, Brazil. E-mail: orsinimarco@hotmail.com Received Date: May 04, 2015 Accepted Date: July 07, 2015 Published Date: July 10, 2015 Citation: Orsini, M., et al. Following the Natural History of a Probable Adrenoleukodystrophy(2015) Int J Neurol Brain Disord 2(2): 1-4. Int J Neurol Brain Disord | Volume 2: Issue 2 www.ommegaonline.com