Carlos Henrique Melo Reis

Motor neuron disease and acquired axonal neuropathy association in HIV infection: case report and update.

BACKGROUND A possible viral etiology has been documented in the genesis of motor neuron disorders and acquired peripheral neuropathies, mainly due to the vulnerability of peripheral nerves and the anterior horn to certain viruses. In recent years, several reports show association of HIV infection with Amyotrophic Lateral Sclerosis - Syndrome, Motor Neuron Diseases and peripheral neuropathies. OBJECTIVE To report a case of an association between Motor Neuron Disease and Acquired Axonal neuropathy in HIV infection, and describe the findings of neurological examination, cerebrospinal fluid, neuroimaging and electrophysiology. METHODS The patient underwent neurological examination. General medical examinations were performed, including, specific neuromuscular tests, analysis of cerebrospinal fluid, muscle biopsy and imaging studies. RESULTS AND DISCUSSION The initial clinical presentation of our case was marked by cramps and fasciculations with posterior distal paresis and atrophy in the left arm. We found electromyography tracings with deficits in the anterior horn of the spinal cord and peripheral nerves. Dysphagia and release of primitive reflexes were also identified. At the same time, the patient was informed to be HIV positive with high viral load. He received antiretroviral therapy, with load control but with no clinical remission. CONCLUSION Motor Neuron disorders and peripheral neuropathy may occur in association with HIV infection. However, a causal relationship remains uncertain. It is noteworthy that the antiretroviral regimen may be implicated in some cases.

Revisiting the Term Neuroprotection in Chronic and Degenerative Diseases.

Thanks to the development of several new researches, the lifetime presented a significant increase, even so, we still have many obstacles to overcome – among them, manage and get responses regarding neurodegenerative diseases. Where we are in the understanding of neuroprotection? Do we really have protective therapies for diseases considered degeneratives such as amyotrophic lateral sclerosis and its variants, Parkinson’s disease, Alzheimer’s disease and many others? Neuroprotection is defined by many researches as interactions and interventions that can slow down or even inhibit the progression of neuronal degeneration process. We make some considerations on this neuroprotective effect.

Gerenciamento da dor na Síndrome Pós-poliomielite: estudo de caso

A Sindrome Pos-Polio (SPP) caracteriza-se por um novo episodio de fraqueza muscular e/ou fadiga muscular anormal em individuos que apresentaram poliomielite anterior aguda (PAA) anos antes. Ainda sao poucos os relatos na literatura sobre o gerenciamento da dor na SSP. O objetivo deste trabalho e analisar o controle da dor na sindrome pos-polio por meio de um relato de caso. Um homem de 57 anos com SPP foi submetido a 24 sessoes de fisioterapia para controle do quadro algico na sindrome, baseada em recursos eletrotermofototerapicos e cinesioterapia. Para analise da dor pre e pos-intervencao fisioterapeutica foram aplicados dois instrumentos: a Escala Analogica Visual (EVA) e a Intensidade de Dor Presente (ID). O quadro algico no joelho direito sofreu reducao de grau 8 para 4 pela EVA e grau 5 para 2 pela ID, enquanto a dor no tornozelo direito reduziu de grau 2 pela EVA e grau 1 pela ID para zero em ambas as escalas. A dor e apontada como um sintoma predominante por muitos pacientes com SPP. O sujeito deste relato, apos o programa de tratamento, apresentou melhora expressiva da dor. Entretanto, devido a escassez da literatura sobre dados substanciais referentes ao seu gerenciamento, especialmente na fisioterapia, novos estudos devem ser propostos para gerar maior fundamentacao teorica a abordagem fisioterapeutica na SPP.

Severity and Functional Ability Scale for Amyotrophic Lateral Sclerosis patients:preliminary results

Recebido em: 01/08/08 Revisado em: 02/08/08 a 03/09/08 Aceito em: 04/09/08 Conflito de interesses: nao Neuromuscular Disease Outpatient Division, Federal Fluminense University – UFF, Antonio Pedro University Hospital – HUAP. Physical Therapist, Chair of the Neurological Rehabilitation, Escola Superior de Ensino Helena Antipoff (ESEHA) and Neuroscience Researcher at UFF. Neurologist, Chair of the Neurology Department and Head of Clinical Neurology Staff, UFF. Neurologist, MD, PhD, Chair of the Neurology Department, UFF. Physical therapist, Department of Neuroscience, UFF. Neuropsychiatry Institute, Instituto de Psiquiatria da Universidade do Brasil, UFRJ. Neurolgist, Neurology Department, Deolindo Couto Neurology Institute, UFRJ. MD, PhD, Neurologist, Department of Neurology, Unifesp. Neurologist, Neurology Department, UFF. Medical Student, UFF. PhD, Psychologist, Neuro-Sono, Department of Neurology, Universidade Federal de Sao Paulo. 1.