Daniel Cincinatus

Polineuropatia por triclorfon registro de um caso com estudo eletrofisiodógico e histopatológico do nervo sural

The authors observed a patient who worked in a farm and suffered an organophosphate intoxication (trichlorphon). The immediate effect was manifested by vomiting and abdominal cramps. Three months later he presented a distal symmetric sensorimotor (predominantly motor) neuropathy with distal muscle atrophy. Electromyography has revealed denervation changes in every muscle studied and the sensory and motor nerve conduction was slowed in arms and legs. The sural nerve biopsy specimen studied by light microscopy with semi-thin section and teased fiber preparation showed axonal degeneration. The ultrastructural studies of the axonal alterations consisted of degeneration of the neurofilaments and the neurotubules with granular appearance of the axoplasm.The authors observed a patient who worked in a farm and suffered an organophosphate intoxication (trichlorfon). The immediate effect was manifested by vomiting and abdominal cramps. Three months later he presented a distal symmetric sensorimotor (predominantly motor) neuropathy with distal muscle atrophy. Electromyography has revealed denervation changes in every muscle studied and the sensory and motor nerve conduction was slowed in arms and legs. The sural nerve biopsy specimen studied by light microscopy with semi-thin section and teased fiber preparation showed axonal degeneration. The ultrastructural studies of the axonal alterations consisted of degeneration of the neurofilaments and the neurotubules with granular appearance of the axoplasm.

Miastenia gravis familiar: registro de dois irmãos

The familiar form of myasthenia gravis is a relatively rare condition, occurring in about 3.4 per cent of myasthenic patients. Two familial cases with ocular myasthenia gravis are reported. They had a third brother who died probably with the same disease. Their parents are cousins. The authors made a brief approach of genetic, clinical, statistical and therapeutics aspects of the disease.

Sindrome de compressão medular como manifestação inicial da doença de Hodgkin: registro de um caso

A case of Hodgkins disease in which the first clinical manifestation was a radiculo-spinal compression is reported. The authors comment about the possible mechanisms to explain this radiculo-spinal compression in this granulomatosis.A case of Hodgkins disease in which the first clinical manifestation was a radiculo-spinal compression is reported. The authors comment about the possible mechanisms to explain this radiculo-spinal compression in this granulomatosis.

Trombose das artérias cerebral anterior e média como primeira manifestação de lupus eritematoso sistêmico: registro de um caso

The case of a young female patient with hemiplegia and aphasia of sudden onset as the initial manifestation of systemic lupus erythematosus is reported. The arteriographic study showed occlusion of the proximal portion of the left anterior cerebral artery and of the trifurcation of the left middle cerebral artery. The neurological manifestations in systemic lupus erythematosus may appear before there is any clinical evidence of involvement of others organs. The authors think that systemic lupus erythematosus should be suspected in every young female patient with acute cerebrovascular accident of unknown etiology.The case of a young female patient with hemiplegia and aphasia of sudden onset as the initial manifestation of systemic lupus erythematosus is reported. The arteriographic study showed occlusion of the proximal portion of the left anterior cerebral artery and of the trifurcation of the left middle cerebral artery. The neurological manifestations in systemic lupus erythematosus may appear before there is any clinical evidence of involvement of others organs. The authors think that systemic lupus erythematosus should be suspected in every young female patient with acute cerebrovascular accident of unknown etiology.

Mielopatia necrotizante e neoplasias: registro clinico-patologico de dois casos

Two clinico-pathological cases of necrotic myelopathies with a distant malignancy are presented. The first patient had histiocytic medullary reticulosis and the second one had a renal cell carcinoma. The authors refered to other similar cases found in the literature. In both patients the pathological features in the spinal cord were similar to the other cases reported, but in their first case they found an intense inflammatory reaction and hyperplasia of astrocytes into bizarre giant forms. The cause of necrotizing myelopathy associated with neoplasms remain unknow. The authors think that the presence of inflammatory reaction and the changes in the astrocytes in their first case are consistent with the effects of a virus.Two clinico-pathological cases of necrotic myelopathies with a distant malignancy are presented. The first patient had histiocytic medullary reticulosis and the second one had a renal cell carcinoma. The authors referred to other similar cases found in the literature. In both patients the pathological features in the spinal cord were similar to the other cases reported, but in their first case they found an intense inflammatory reaction and hyperplasia of astrocytes into bizarre giant forms. The cause of necrotizing myelopathy associated with neoplasms remain unknown. The authors think that the presence of inflammatory reaction and the changes in the astrocytes in their first case are consistent with the effects of a virus.

Encefalopatia mioclonica pos-anoxica (sindrome de Lance-Adams): estudo anatomopatológico de dois casos

Foram feitos estudos neuropatologicos em dois casos de pacientes que apresentaram encefalopatia mioclonica pos-anoxica (sindrome de Lance-Adams). O encefalo mostrou lesoes neuronais difusas, comprometendo principalmente o cortice, talamo e estruturas sub-talâmicas, desde lesoes discretas caracterizadas pela presenca de vacuolos intracitoplasmaticos (primeira alteracao vista na anoxia) ate neuronios totalmente degenerados, notando-se varios neuronios com lesoes classicas de isquemia. A presenca de material de inclusao anfofilica discretamente PAS positiva observado no citoplasma neuronal foi diferente das inclusoes verificadas nos casos de epilepsia mioclonica com corpusculos de Lafora. Nao conseguimos identificar a constituicao destas inclusoes, apesar de serem feitos diferentes metodos de coloracao. Nao encontramos tambem, na literatura, referencia a tal tipo de inclusao. Foram tambem encontradas alteracoes vasculares, consistindo de vasos proliferados com celulas endoteliais tumefeitas. Tais celulas apresentaram-se com disposicao anarquica, provavelmente devidas a anoxia isquemica. A diferenca dos achados anatomopatologicos, entre os casos 1 e 2, sao provavelmente decorrentes do mecanismo diverso da instalacao da anoxia.Two cases of Lance-Adams syndrome with anatomopathologic study are reported. There were evidences of diffuse neuronal degeneration in the brain. These changes were most seen in the neurones of the cortical layers, thalamus and subthalamic nuclei. The cells changes were similar of those seen in ischaemic disease. Some neurones showed intracytoplasmatic inclusions staining with the P.A.S. method. These inclusions were readily distinguished from the Lafora bodies.

Mucolipidose do tipo II: registro de dois casos sugestivos

The clinical and laboratorial study of two brothers with gargoylism is reported. The examination of the urine showed normal findings of mucopolysaccharides. The authors made differential diagnoses with others mucolipidoses and concluded that mucolipidose type II should be concidered in any patient with gargoylism.

Trombose da arteria carotida interna no curso e doença reumatica: registro de um caso

The case of a 21 years old man with hemiplegia and hyperthermia of sudden onset is reported. The angiographic study showed thrombosis of the distal portion of the internal carotid artery. Laboratorial studies revealed positive rheumatic tests. The authors think that the rheumatic arteritis may be responsible for this ischemic cerebral accident. Differential diagnosis with the embolic accidents caused by the rheumatic disease is discussed.The case of a 21 years old man with hemiplegia and hyperthermia of sudden onset is reported. The angiographic study showed thrombosis of the distal portion of the internal carotid artery. Laboratorial studies revealed positive rheumatic tests. The authors think that the rheumatic arteritis may be responsible for this ischemic cerebral accident. Differential diagnosis with the embolic accidents caused by the rheumatic disease is discussed.