Arquivos de neuro-psiquiatria
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About 60% of women with migraine associate their headache attacks to the menstrual period. Regarding the non-migrainous headaches, this relationship is not so clear. The aim of this study is to present a clinical evaluation of menstrual headaches. ⋯ Most part of the headaches began two days before the first day of the menstrual flow. Nauseas and/or vomiting were the most frequent associated symptoms. Finally, we found, among the menstrual headaches, 9 cases of tension type headache, 2 cases of cervicogenic headache and 1 case of stabbing headache.
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Case Reports
Disseminated tuberculosis in a pregnant woman presenting with numerous brain tuberculomas: case report.
Tuberculosis is an infectious disease caused by Mycobacterium tuberculosis, which has the pulmonary form as the most common presentation. Dissemination of the disease is common in immunocompromised patients, but immunodeficiency related to pregnancy severe enough to cause dissemination of the Mycobacteria is exceedingly rare. When dissemination occurs, any organ may be affected and in central nervous system, the infection presents as meningitis and single brain parenchyma tuberculomas. ⋯ The patient underwent a craniotomy with biopsy of the lesions confirming the diagnosis of brain tuberculomas. The three-drug regimen was started and the cranial CT scan performed a year after diagnosis showed no brain lesions. We emphasize the aggressive dissemination of the disease in this case associated with pregnancy and the importance of early diagnosis and institution of therapy resulting in regression of the lesions.
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Case Reports
Hoffman's syndrome: pseudohypertrophic myopathy as initial manifestation of hypothyroidism. Case report.
The frequency of myopathy in hypothyroidism ranges from 30 to 80%. The major symptoms related are weakness, muscular cramps and myalgia. The pseudohyperthrophic form is called Hoffman's syndrome. ⋯ We report an adult male who developed muscular cramps, myalgia, weakness, pseudohyperthrophy, associated with facial edema and alteration of his voice. The muscle enzymes were increased and T4 was undetectable with a raised level of TSH. The myopathy was the initial manifestation of hypothyroidism in this case.
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Comparative Study
[Epilepsy surgery in childhood: neuropsychological and quality of life assessments].
To perform neuropsychological and quality of life assessments before and after epilepsy surgery in children; to correlate these parameters with clinical findings. ⋯ Quality of life improvement was clearly correlated with seizure control; nevertheless, neuropsychological improvement depended on several factors, such as etiology, type of epilepsy and surgery.
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Case Reports
[Botulinum toxin type B in the management of dystonia non-responsive to botulinum toxin type A].
Botulinum toxin (BTX) injection is the first choice treatment for focal dystonias. However 10% or more of patients who receive repetitive injections of BTX type A (BTX-A) lose response (secondary non-responders). One of the strategies to manage such patients is to treat them with another serotype. The aim of this article is to describe my experience with BTX type B (BTX-B) in the management of patients with focal dystonia who became secondary non-responders to BTX-A. ⋯ My findings confirm that BTX-B injections are a safe and effective option for the management of dystonia patients who become secondary non-responders to BTX-A. The results also underscore the need of individualizing dosage regimens before optimum results are achieved.