Damacio Ramón Kaimen Maciel

Restless legs syndrome and multiple sclerosis: a Brazilian multicenter study and meta-analysis of the literature

OBJECTIVE The increased prevalence of restless legs syndrome (RLS) in multiple sclerosis (MS) has recently been the subject of a few papers. The present study investigated the prevalence of RLS symptoms in MS patients and in controls in four Brazilian cities. Additionally, a systematic review and meta-analysis of the literature was carried out on the subject of RLS-MS. METHOD MS patients and controls were investigated regarding the presence of the four typical symptoms of RLS. A questionnaire assessing RLS severity was also used for patients and controls presenting the four RLS symptoms criteria. The systematic review and meta-analysis on the subject were carried out according to the strict international criteria. RESULTS In the present report, the RLS-MS association was confirmed as being more than fortuitous in Brazilian MS patients, in a multicenter case-control study. MS patients also presented RLS symptoms of greater severity than did the control population. A systematic review and meta-analysis of the literature showed that MS patients had a fourfold higher chance of presenting RLS than did the controls. CONCLUSION Although underlying mechanisms to explain the association RLS-MS are still a matter of discussion, there is a clear association of these two neurological conditions.

CONSENSO EXPANDIDO DO BCTRIMS PARA O TRATAMENTO DA ESCLEROSE MÚLTIPLA I. As evidências para o uso de imunossupressores, plasmaférese e transplante autólogo de células tronco

Since the sixties immunosuppressive agents have been used in the treatment of multiple sclerosis as there was cumulating evidence of the inflammatory nature of the disease. Cyclophosphamide, azathioprine and methotrexate have been the most frequently employed drugs whereas other agents such as cyclosporine and cladribine have been recently tested for RRMS. Mithoxantrone, on the other hand, was approved by the FDA for treatment of aggressive forms of the disease. Other immunointerventions such as plasma exchange and autologous hematopoietic stem cell transplantation have recently been employed in some special circumstances. This paper analyses the most important published data on the use of the immunosuppressive agents, plasma exchange and autologous hematopoietic stem cell transplantation according to the classes of evidences and types of recommendations of these drugs and immunointerventions. It provides sufficient information to support the guidelines expressed in the BCTRIMS Expanded Consensus on Treatment of MS.

Granuloma esquistossomotico medular: registro de um caso

Os autores relatam um caso de granuloma esquistossomotico de localizacao medular cujo diagnostico inicial, foi de tumor intramedular sem caracterizacao nosologica. O resultado e diagnostico, apos exame histologico da peca cirurgica, bem como aspectos diagnosticos atraves de exames complementares e caracteristicas endemicas do processo sao discutidos.

Tuberculomas intracranianos: relato de dois casos

Preoperative diagnosis of intracranial tuberculoma is often difficult and, at present, this process is very rare in some countries. The authors report two recent cases, with radical removal of the process, in which the diagnosis was post-operative. Some diagnosis features and treatment in intracranial tuberculomas are discussed.

Meningeoma ectopico do calvario: registro de um caso

A case of calvarial meningeoma in a 42 year old female is reported. Arising from the inner table of the skull, it projected a extracranial mass without neurological simptomatology. The surgical procedure give good results. Some aspects of the literature and radiologics finds are commented. The infrequency of this pathology is ressalted.

Meningeoma intraventricular: registro de um caso

A case of meningeoma located at the right lateral ventricle is reported. The tumor was successfully removed by surgery. The authors justified this report by the infrequency of the pathology. Some aspects of the literature are commented.A case of meningeoma located at the right lateral ventricle is reported. The tumor was succesfully removed by surgery. The authors justified this report by the infrequency of the pathology. Some aspects of the literature are commented.

Trombose traumática da artéria carótida associada a fístula carótido-cavernosa ipsolateral tardia

Os autores relatam um caso de obstrucao traumatica de carotida associada a fistula carotido-cavernosa homolateral tardia. Sao comentados aspectos da sintomatologia clinica e do resultado obtido pelo tratamento da fistula.