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de Assis Franco I, Florinda AMDA, Gonçalves FG, Rodrigues MM, Vale TC. Phenylketonuria in three siblings. Pract Neurol 2023; 23:525-526. [PMID: 37487703 DOI: 10.1136/pn-2023-003815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Igor de Assis Franco
- Department of Neurology, Hospital e Maternidade São José, Conselheiro Lafaiete, Brazil
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Pedroso JL, Vale TC, Freitas JLD, Araújo FMM, Meira AT, Neto PB, França MC, Tumas V, Teive HAG, Barsottini OGP. Movement disorders in hereditary spastic paraplegias. Arq Neuropsiquiatr 2023; 81:1000-1007. [PMID: 38035585 PMCID: PMC10689114 DOI: 10.1055/s-0043-1777005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/22/2023] [Indexed: 12/02/2023]
Abstract
BACKGROUND Hereditary or familial spastic paraplegias (SPG) comprise a group of genetically and phenotypically heterogeneous diseases characterized by progressive degeneration of the corticospinal tracts. The complicated forms evolve with other various neurological signs and symptoms, including movement disorders and ataxia. OBJECTIVE To summarize the clinical descriptions of SPG that manifest with movement disorders or ataxias to assist the clinician in the task of diagnosing these diseases. METHODS We conducted a narrative review of the literature, including case reports, case series, review articles and observational studies published in English until December 2022. RESULTS Juvenile or early-onset parkinsonism with variable levodopa-responsiveness have been reported, mainly in SPG7 and SPG11. Dystonia can be observed in patients with SPG7, SPG11, SPG22, SPG26, SPG35, SPG48, SPG49, SPG58, SPG64 and SPG76. Tremor is not a frequent finding in patients with SPG, but it is described in different types of SPG, including SPG7, SPG9, SPG11, SPG15, and SPG76. Myoclonus is rarely described in SPG, affecting patients with SPG4, SPG7, SPG35, SPG48, and SPOAN (spastic paraplegia, optic atrophy, and neuropathy). SPG4, SPG6, SPG10, SPG27, SPG30 and SPG31 may rarely present with ataxia with cerebellar atrophy. And autosomal recessive SPG such as SPG7 and SPG11 can also present with ataxia. CONCLUSION Patients with SPG may present with different forms of movement disorders such as parkinsonism, dystonia, tremor, myoclonus and ataxia. The specific movement disorder in the clinical manifestation of a patient with SPG may be a clinical clue for the diagnosis.
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Affiliation(s)
- Jose Luiz Pedroso
- Universidade Federal de São Paulo, Departamento de Neurologia, São Paulo SP, Brazil.
| | - Thiago Cardoso Vale
- Universidade Federal de Juiz de Fora, Hospital Universitário, Departamento de Clínica Médica, Serviço de Neurologia, Juiz de Fora MG, Brazil.
| | | | - Filipe Miranda Milagres Araújo
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências Comportamental, Ribeirão Preto SP, Brazil.
| | - Alex Tiburtino Meira
- Universidade Federal da Paraíba, Departamento de Medicina Interna, Serviço de Neurologia, João Pessoa PB, Brazil.
| | - Pedro Braga Neto
- Universidade Federal do Ceará, Departamento de Medicina Clínica, Divisão de Neurologia, Fortaleza CE, Brazil.
- Universidade Estadual do Ceará, Centro de Ciências da Saúde, Fortaleza CE, Brazil.
| | - Marcondes C. França
- Universidade Estadual de Campinas, Departamento de Neurologia, Campinas SP, Brazil.
| | - Vitor Tumas
- Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências Comportamental, Ribeirão Preto SP, Brazil.
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Massuyama BK, Vale TC, Rezende Filho FM, Barsottini OGP, Pedroso JL. Downbeat nystagmus and progressive ataxia in adults: consider Chiari malformation type 1. Arq Neuropsiquiatr 2023; 81:937-938. [PMID: 37774743 PMCID: PMC10631855 DOI: 10.1055/s-0043-1771171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/16/2023] [Indexed: 10/01/2023]
Affiliation(s)
- Breno Kazuo Massuyama
- Universidade Federal de São Paulo, Departamento de Neurologia, Unidade de Ataxia, São Paulo SP, Brazil.
| | - Thiago Cardoso Vale
- Universidade Federal de Juiz de Fora, Departamento de Medicina Interna, Juiz de Fora MG, Brazil.
| | | | | | - José Luiz Pedroso
- Universidade Federal de São Paulo, Departamento de Neurologia, Unidade de Ataxia, São Paulo SP, Brazil.
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Silva DP, Coelho M, Soares T, Vale TC, Correia Guedes L, Maciel ROH, Antunes AP, Camargos ST, Valadas A, Godinho C, Maia DP, Pita Lobo P, Maia RD, Teodoro T, Rieder CR, Velon AG, Tumas V, Barbosa ER, Teive HA, Ferraz HB, Rosas MJ, Calado A, Lampreia T, Simões R, Vila‐Chã N, Costa MM, Rodrigues AM, Caniça V, Cardoso F, Ferreira JJ. Handicap as a Measure of Perceived-Health Status in Parkinson's Disease. Mov Disord Clin Pract 2023; 10:1172-1180. [PMID: 37635780 PMCID: PMC10450228 DOI: 10.1002/mdc3.13826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 05/31/2023] [Accepted: 06/11/2023] [Indexed: 08/29/2023] Open
Abstract
Background Handicap is a patient-centered measure of health status that encompasses the impact of social and physical environment on daily living, having been assessed in advanced and late-stage Parkinson's Disease (PD). Objective To characterize the handicap of a broader sample of patients. Methods A cross-sectional study of 405 PD patients during the MDS-UPDRS Portuguese validation study, using the MDS-UPDRS, Unified Dyskinesias Rating Scale, Nonmotor symptoms questionnaire, PDQ-8 and EQ-5D-3L. Handicap was measured using the London Handicap Scale (LHS). Results Mean age was 64.42 (±10.3) years, mean disease duration 11.30 (±6.5) years and median HY 2 (IQR, 2-3). Mean LHS was 0.652 (±0.204); "Mobility," "Occupation" and "Physical Independence" were the most affected domains. LHS was significantly worse in patients with longer disease duration, older age and increased disability. In contrast, PDQ-8 did not differentiate age groups. Handicap was significantly correlated with disease duration (r = -0.35), nonmotor experiences of daily living (EDL) (MDS-UPDRS-I) (r = -0.51), motor EDL (MDS-UPDRS-II) (r = -0.69), motor disability (MDS-UPDRS-III) (r = -0.49), axial signs of MDS-UPDRS-III (r = -0.55), HY (r = -0.44), presence of nonmotor symptoms (r = -0.51) and PDQ-8 index (r = -0.64) (all P < 0.05). Motor EDL, MDS-UPDRS-III and PDQ-8 independently predicted Handicap (adjusted R 2 = 0.582; P = 0.007). Conclusions The LHS was easily completed by patients and caregivers. Patients were mild-moderately handicapped, which was strongly determined by motor disability and its impact on EDL, and poor QoL. Despite correlated, handicap and QoL seem to differ in what they measure, and handicap may have an added value to QoL. Handicap seems to be a good measure of perceived-health status in a broad sample of PD.
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Affiliation(s)
- Daniela Pimenta Silva
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
| | - Miguel Coelho
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
- Instituto de Medicina MolecularLisbonPortugal
| | | | | | - Leonor Correia Guedes
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
- Instituto de Medicina MolecularLisbonPortugal
| | | | - Ana Patrícia Antunes
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
| | | | - Anabela Valadas
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
- Instituto de Medicina MolecularLisbonPortugal
| | - Catarina Godinho
- Grupo de Patologia Médica, Nutrição e Exercício Clínico (PaMNEC) do Centro de Investigação Interdisciplinar Egas Moniz (CiiEM)
| | - Débora Palma Maia
- Movement Disorders UnitFederal University of Minas GeraisBelo HorizonteBrazil
| | - Patrícia Pita Lobo
- Department of Neurosciences and Mental HealthHospital de Santa Maria, CHULNLisbonPortugal
- Instituto de Medicina MolecularLisbonPortugal
| | - Raphael Doyle Maia
- Movement Disorders Unit, Hospital Universitário Cassiano Antônio MoraesFederal University of Espírito SantoEspírito SantoBrazil
| | - Tiago Teodoro
- Instituto de Medicina MolecularLisbonPortugal
- Atkinson Morley Regional Neuroscience Centre, St. George's University Hospitals National Health Service Foundation TrustLondonUnited Kingdom
- Neuroscience Research Centre, Institute of Molecular and Clinical SciencesSt. George's University of LondonLondonUK
| | - Carlos R. Rieder
- Movement Disorders UnitHospital Santa Casa de Misericórdia de Porto AlegrePorto AlegreBrazil
- Federal University of Health Sciences of Porto AlegrePorto AlegreBrazil
| | - Ana Graça Velon
- Serviço de Neurologia do Centro Hospitalar de Trás‐os‐Montes e Alto DouroVila RealPortugal
| | - Vítor Tumas
- Department of Neuroscience and Behavior Sciences, Ribeirão Preto School of MedicineUniversity of São PauloRibeirão PretoBrazil
| | - Egberto Reis Barbosa
- Universidade de São Paulo, Faculdade de MedicinaDepartamento de Neurologia, Centro de Distúrbios do MovimentoSão PauloBrazil
| | - Hélio A.G. Teive
- Department of NeurologyUniversidade Federal do ParanáCuritibaBrazil
| | | | | | - Ana Calado
- Serviço de Neurologia do Centro Hospitalar de Lisboa CentralLisbonPortugal
| | - Tânia Lampreia
- Serviço de NeurologiaHospital Egas Moniz, Centro Hospitalar Lisboa OcidentalLisbonPortugal
| | - Rita Simões
- Serviço de NeurologiaHospital Beatriz ÂngeloLisbonPortugal
| | - Nuno Vila‐Chã
- Serviço de Neurologia do Hospital de Santo António, Centro Hospitalar Universitário do PortoPortoPortugal
| | - Maria Manuela Costa
- Serviço de NeurologiaHospital Pedro HispanoMatosinhosPortugal
- Serviço de NeurologiaHospital das Forças ArmadasPortoPortugal
| | | | | | - Francisco Cardoso
- Movement Disorders UnitFederal University of Minas GeraisBelo HorizonteBrazil
| | - Joaquim J. Ferreira
- CNS – Campus NeurológicoTorres VedrasPortugal
- Laboratory of Clinical Pharmacology, Faculty of MedicineUniversity of LisbonLisbonPortugal
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Vale TC, Cardoso FEC, da Silva DJ, Resende EDPF, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Teixeira AL, Caramelli P, Barbosa MT. Clinical and functional correlates of parkinsonism in a population-based sample of individuals aged 75 + : the Pietà study. BMC Neurol 2023; 23:276. [PMID: 37479964 PMCID: PMC10360246 DOI: 10.1186/s12883-023-03290-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 06/16/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Parkinsonism is strongly associated with ageing, and many studies have suggested that parkinsonian signs may affect up to half of older adults and is associated with a wide range of adverse health outcomes. We compared clinical and functional characteristics of oldest-old community-dwelling individuals with parkinsonism (parkinsonian group [PG]) to individuals without parkinsonism (non-parkinsonian group [NPG]. METHODS The Pietà study is a population-based study conducted in Caeté, southeast Brazil, involving 607 individuals aged 75 + years submitted to an extensive clinical evaluation. A subset of 65 PG individuals (61.5% women, median age of 82 years) was compared to 542 NPG individuals (64.8% women, median age of 80 years). RESULTS PG individuals had significantly more functional impairment, clinical comorbidities (including number of falls, loss of bladder control and dysphagia) and major depression. Multivariate analysis revealed that older age, higher UPDRSm scores, lower category fluency test (animals/minute) and delayed recall memory scores were associated with PG. This group was also more cognitively impaired, with lower performance than NPG individuals in the Mini-Mental State Examination, category fluency test (animals/minute), clock drawing and in delayed recall (p < 0.001 for all tests). UPDRSm scores were the most contributing factor to cognition that independently explained variability in functionality of the entire sample. CONCLUSION Individuals aged 75 + years with parkinsonism were significantly more clinically and functionally impaired in this population-based sample. Cognitive dysfunction explained most of the loss of functionality in these patients. UPDRS-m scores contributed independently to explain variability in functionality in the whole sample.
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Affiliation(s)
- Thiago Cardoso Vale
- Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
- Movement Disorders Unit, Hospital Universitário, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil.
| | - Francisco Eduardo Costa Cardoso
- Movement Disorders Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Danilo Jorge da Silva
- Internal Medicine Department, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Elisa de Paula Franca Resende
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Palma Maia
- Movement Disorders Unit, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Antônio Lúcio Teixeira
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Unit, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
- Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, Brazil
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Perpetuo LH, Ferreira W, da Silva DJ, Jurno ME, Vale TC. Incidence Rate and Factors Associated with Delirium and Subsyndromal Delirium in Patients with COVID-19 in an Intensive Care Unit. J Clin Med 2023; 12:jcm12113789. [PMID: 37297983 DOI: 10.3390/jcm12113789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 05/17/2023] [Accepted: 05/26/2023] [Indexed: 06/12/2023] Open
Abstract
BACKGROUND Delirium subsyndrome (SSD) and delirium (DL) are known complications in the intensive care unit (ICU) and are associated with worse clinical outcomes. The aim of this study was to screen for SSD and DL in individuals with COVID-19 admitted to the ICU and to study the associated factors and clinical outcomes. METHOD An observational, longitudinal study was conducted in the reference ICU for COVID-19. All admitted individuals with COVID-19 were screened for SSD and DL during their ICU stay using the Intensive Care Delirium Screening Checklist (ICDSC). Individuals with SSD and/or DL were compared to those without SSD and/or DL. RESULTS Ninety-three patients were evaluated, of which 46.7% had SSD and/or DL. The incidence rate was 4.17 cases/100 person-days. Individuals with SSD and/or DL had higher severity of illness on admission to the ICU, as measured by the APACHE II score (median 16 versus 8 points, p < 0.001). SSD and/or DL were associated with longer ICU and hospital stays (median 19 versus 6 days, p < 0.001 and median 22 versus 7 days, p < 0.001, respectively). CONCLUSION Individuals with SSD and/or DL had greater disease severity and longer ICU and hospital stays when compared to those without SSD and/or DL. This reinforces the importance of screening for consciousness disorders in the ICU.
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Affiliation(s)
- Lara Helena Perpetuo
- Programa de Pós-Graduação em Saúde, Faculdade de Medicina, Associação Hospitalar Bom Jesus de Congonhas, Universidade Federal de Juiz de Fora, Congonhas 36415-000, MG, Brazil
| | - Wellington Ferreira
- Faculdade de Medicina, Universidade Federal de São João Del Rei, Divinópolis 35501-296, MG, Brazil
| | - Danilo Jorge da Silva
- Programa de Pós-Graduação em Saúde, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil
| | | | - Thiago Cardoso Vale
- Programa de Pós-Graduação em Saúde, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora 36036-900, MG, Brazil
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Pedroso JL, Vale TC, França Junior MC, Kauffman MA, Teive H, Barsottini OGP, Munhoz RP. A Diagnostic Approach to Spastic ataxia Syndromes. Cerebellum 2022; 21:1073-1084. [PMID: 34782953 DOI: 10.1007/s12311-021-01345-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/08/2021] [Indexed: 06/13/2023]
Abstract
Spastic ataxia is characterized by the combination of cerebellar ataxia with spasticity and other pyramidal features. It is the hallmark of some hereditary ataxias, but it can also occur in some spastic paraplegias and acquired conditions. It often presents with heterogenous clinical features with other neurologic and non-neurological symptoms, resulting in complex phenotypes. In this review, the differential diagnosis of spastic ataxias are discussed and classified in accordance with inheritance. Establishing an organized classification method based on mode inheritance is fundamental for the approach to patients with these syndromes. For each differential, the clinical features, neuroimaging and genetic aspects are reviewed. A diagnostic approach for spastic ataxias is then proposed.
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Affiliation(s)
- José Luiz Pedroso
- Department of Neurology, Ataxia Unit, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - Thiago Cardoso Vale
- Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | - Marcelo A Kauffman
- Laboratorio de Neurogenética, Centro Universitario de Neurología "José María Ramos Mejía" y División Neurología, Hospital JM Ramos Mejía, Facultad de Medicina, UBA, Buenos Aires, Argentina
| | - Helio Teive
- Department of Neurology, Universidade Federal do Paraná, Curitiba, PR, Brazil
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Pedroso JL, Vale TC, Meira AT, Braga-Neto P, Barsottini OGP, Espay AJ. Dystonia, Chorea, and Ataxia: Three Challenging Cases. Semin Neurol 2022; 42:735-741. [PMID: 36580980 DOI: 10.1055/s-0042-1760232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Movement disorders comprise a heterogeneous and complex group of neurological disorders that increase (hyperkinetic) or decrease (hypokinetic) the speed or amplitude of movements, or disrupt their coordinated sequencing. In this article, we describe three instructive cases, exemplifying classic movement disorders, namely dystonia, chorea, and ataxia. We highlight the diagnostic approach based on clinical clues, syndromic reasoning, evaluation, and management recommendations. Each case ends with key messages for the clinicians.
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Affiliation(s)
- José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Thiago Cardoso Vale
- Department of Neurology, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Alex Tiburtino Meira
- Department of Neurology, Universidade Federal da Paraíba, João Pessoa, Paraíba, Brazil
| | - Pedro Braga-Neto
- Department of Neurology, Universidade Federal do Ceará, Fortaleza, Ceará, Brazil
| | - Orlando G P Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Sao Paulo, Brazil
| | - Alberto J Espay
- Gardner Neuroscience Institute, Gardner Center for Parkinson's Disease and Movement Disorders, University of Cincinnati, Cincinnati, Ohio
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de Oliveira DS, Pedroso JL, Barsottini O, Tomaselli PJ, Marques Júnior W, Vale TC. Small-Expanded Allele Spinocerebellar Ataxia Type 17 Leading to Broad Movement Disorder Phenotype in a Brazilian Patient. Cerebellum 2022; 21:1151-1153. [PMID: 34738227 DOI: 10.1007/s12311-021-01339-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/21/2021] [Indexed: 06/13/2023]
Affiliation(s)
- Daniel Sabino de Oliveira
- Neurology Service, University Hospital, Universidade Federal de Juiz de Fora (UFJF), Avenida Catulo Breviglieri s/n, Bairro Santa Catarina, Juiz de Fora, MG, CEP 36036-110, Brazil
| | - José Luiz Pedroso
- Department of Neurology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Orlando Barsottini
- Department of Neurology, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Pedro José Tomaselli
- Department of Neurology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
- International Center for Genomic Medicine in Neuromuscular Diseases, Sheffield, UK
| | - Wilson Marques Júnior
- Department of Neurology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
- International Center for Genomic Medicine in Neuromuscular Diseases, Sheffield, UK
| | - Thiago Cardoso Vale
- Neurology Service, University Hospital, Universidade Federal de Juiz de Fora (UFJF), Avenida Catulo Breviglieri s/n, Bairro Santa Catarina, Juiz de Fora, MG, CEP 36036-110, Brazil.
- Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil.
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10
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de Oliveira DS, Brandão AI, Vale TC. Fragile X-associated tremor or ataxia syndrome in a patient with difficulty walking, falls, a tremor, and erectile dysfunction. Lancet 2022; 400:1144. [PMID: 36183730 DOI: 10.1016/s0140-6736(22)01587-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 06/29/2022] [Accepted: 08/09/2022] [Indexed: 10/14/2022]
Affiliation(s)
- Daniel Sabino de Oliveira
- Neurology Service, Hospital Universitário da Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - André Iglesias Brandão
- Neurology Service, Hospital Universitário da Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
| | - Thiago Cardoso Vale
- Neurology Service, Hospital Universitário da Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil; Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
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Costa SCG, Rezende‐Filho FC, Freitas JL, Assis Pereira Matos PCA, Della‐Ripa B, França MC, Marques W, Santos M, Cronemberger IVB, Vale TC, Kok F, Alonso I, Pedroso JL, Barsottini OG. Clinical and Genetic Characterization of Brazilian Patients with Ataxia and Oculomotor Apraxia. Mov Disord 2022; 37:1309-1316. [PMID: 35426160 DOI: 10.1002/mds.29015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 01/30/2022] [Accepted: 03/06/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Ataxia with oculomotor apraxia (AOA) is characterized by early-onset cerebellar ataxia associated with oculomotor apraxia. AOA1, AOA2, AOA3, and AOA4 subtypes may present pathogenic variants in APTX, SETX, PIK3R5, and PNKP genes, respectively. Mutations in XRCC1 have been found to cause autosomal recessive spinocerebellar ataxia-26 (SCAR26) now considered AOA5. OBJECTIVES To examine a cohort of Brazilians with autosomal recessive cerebellar ataxia plus oculomotor apraxia and determine the frequencies of AOA subtypes through genetic investigation. METHODS We evaluated clinical, biomarkers, electrophysiological, and radiological findings of 52 patients with AOA phenotype and performed a genetic panel including APTX, SETX, PIK3R5, PNKP, and XRCC1. RESULTS We found pathogenic variants in SETX (15 patients), PNKP (12), and APTX (5). No mutations in PIK3R5 or XRCC1 were identified. CONCLUSIONS AOA2 and AOA4 were the most common forms of AOA in Brazil. Mutations in PIK3R5 and XRCC1 were not part of this genetic spectrum. © 2022 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sophia Caldas Gonzaga Costa
- Division of General Neurology and Ataxia Unit, Department of Neurology Universidade Federal de São Paulo Sao Paulo SP Brazil
| | - Flávio c Rezende‐Filho
- Division of General Neurology and Ataxia Unit, Department of Neurology Universidade Federal de São Paulo Sao Paulo SP Brazil
| | - Júlian Leticia Freitas
- Division of General Neurology and Ataxia Unit, Department of Neurology Universidade Federal de São Paulo Sao Paulo SP Brazil
| | | | - Bruno Della‐Ripa
- Department of Neurology Universidade de São Paulo São Paulo SP Brazil
| | | | - Wilson Marques
- Department of Neurology Universidade de São Paulo Ribeirão Preto SP Brazil
| | - Mariana Santos
- UnIGENe, IBMC ‐ Institute for Molecular and Cell Biology, i3S ‐ Instituto de Investigação e Inovação em Saúde, Universidade do Porto Porto Porto Portugal
| | | | - Thiago Cardoso Vale
- Departamento de Clínica Médica, Faculdade de Medicina Universidade Federal de Juiz de Fora Juiz de Fora MG Brazil
| | - Fernando Kok
- Department of Neurology Universidade de São Paulo São Paulo SP Brazil
| | - Isabel Alonso
- UnIGENe, IBMC ‐ Institute for Molecular and Cell Biology, i3S ‐ Instituto de Investigação e Inovação em Saúde, Universidade do Porto Porto Porto Portugal
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology Universidade Federal de São Paulo Sao Paulo SP Brazil
| | - Orlando G.P. Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology Universidade Federal de São Paulo Sao Paulo SP Brazil
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12
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Franco IDA, Vale TC, Freitas LF, Barbosa AVS, Aragão MDM, Rodrigues MM. Obstructive Hydrocephalus Presenting with Bobble-Head Doll Syndrome. Neuropediatrics 2022; 53:78-79. [PMID: 34448182 DOI: 10.1055/s-0041-1733775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Igor de Assis Franco
- Department of Neurology, Hospital e Maternidade São José, Conselheiro Lafaiete, Minas Gerais, Brazil
| | - Thiago Cardoso Vale
- Departament of Internal Medicine, Faculdade de Medicina, Universidade Federal de Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | | | | | - Marcelo de Melo Aragão
- Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Sao Paulo, Brazil
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13
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Toso FF, Vale TC, Pedroso JL, Ferraz HB, Barsottini OGP. Limb myorhythmia from spinal cord glioma. Pract Neurol 2021; 22:77-78. [PMID: 34649985 DOI: 10.1136/practneurol-2021-003147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Fabio Fieni Toso
- Department of Neurology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Thiago Cardoso Vale
- Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - José Luiz Pedroso
- Department of Neurology, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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14
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de Assis Franco I, Vale TC, Schulze VH, Goncalves MVM. Painful legs and moving toes. Pract Neurol 2021; 21:practneurol-2021-002958. [PMID: 33875548 DOI: 10.1136/practneurol-2021-002958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2021] [Indexed: 11/03/2022]
Abstract
A 40-year-old woman reported involuntary and irregular movements of her left toes accompanied by pain. This arose following arthroscopy after a sprained left ankle. She had involuntary flexion-extension and abduction and adduction movements of the hallux and the other toes, with reduced pinprick sensation on the skin web between the left hallux and the second toe. Nerve conduction studies confirmed a deep peroneal nerve axonal injury. We diagnosed the syndrome of painful legs and moving toes, provoked by a peripheral nerve injury. Her symptoms have persisted despite pregabalin, gabapentin and amitriptyline.
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Affiliation(s)
- Igor de Assis Franco
- Department of Neurology, Hospital e Maternidade São José, Conselheiro Lafaiete, Brazil
| | - Thiago Cardoso Vale
- Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
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15
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Vale TC, Povoas Barsottini OG, Pedroso JL. Family history as a clue to the diagnosis of orofacial abnormal movements in a 30-year-old man. Parkinsonism Relat Disord 2020; 85:146-148. [PMID: 33191097 DOI: 10.1016/j.parkreldis.2020.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 11/28/2022]
Abstract
A 30-year-old man presented with a two-year history of involuntary movements in the face and mouth. Movements progressively worsened during the previous six months. Born from non-consanguineous parents, he had normal developmental milestones and his past medical history was unremarkable. The patient did not take any medication or had a history of illicit drug use. Family history was positive for unsteady gait of unknown cause. Neurological examination disclosed isolated orofacial dystonia affecting the face, particularly his mouth and eyes, resembling Meige's syndrome. Dystonic closure of eyelids and dystonic contractions of orbicularis oris and platysma were particularly visible while patient was talking. The Montreal Cognitive Assessment score was 30. There were no other movement disorders or other abnormalities in neurological examination. Of note, cerebellar examination as well as gait assessment were normal.
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Affiliation(s)
- Thiago Cardoso Vale
- Movement Disorders Unit, Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil.
| | | | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal de São Paulo, Sao Paulo, Brazil.
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16
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De Oliveira DS, Santos DP, Araujo DO, Tomaselli PJ, Júnior WIM, Vale TC. Huntington's disease-like 2: a phenocopy not to miss. Pract Neurol 2020; 20:479-481. [PMID: 32994366 DOI: 10.1136/practneurol-2020-002590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/03/2020] [Indexed: 11/04/2022]
Abstract
A 67-year-old Brazilian man of African ancestry and his 60-year-old sister both presented with choreiform movements, although in the man these were significantly overshadowed by additional parkinsonism. The man also had a history of four epileptic seizures. Neurological examination in each also found slow saccades and a dysexecutive syndrome. Genetic tests for Huntington's disease were negative but were positive for Huntington's disease-like 2. There are various genetic causes of chorea diseases, and their correct identification is important for appropriate clinical management and genetic counselling.
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Affiliation(s)
| | - Daniela Pereira Santos
- Neurology Service, University Hospital, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Daniel Oliveira Araujo
- Neurology Service, University Hospital, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
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17
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Cruzeiro MM, Vale TC, Marrone CD. Symptomatic female carriers of mutations in the Duchenne muscular dystrophy gene. Arq Neuropsiquiatr 2020; 78:598-599. [PMID: 32935735 DOI: 10.1590/0004-282x20200061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/23/2020] [Indexed: 11/21/2022]
Affiliation(s)
- Marcelo Maroco Cruzeiro
- Universidade Federal de Juiz de Fora, Departamento de Clínica Médica, Juiz de Fora MG, Brazil
| | - Thiago Cardoso Vale
- Universidade Federal de Juiz de Fora, Departamento de Clínica Médica, Juiz de Fora MG, Brazil
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18
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Paula TG, Vale TC, Pedroso JL, Barsottini OGP. Postsurgical Myoclonus of the Pectoralis Major. Mov Disord Clin Pract 2020; 7:716-717. [DOI: 10.1002/mdc3.12975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/04/2020] [Accepted: 05/06/2020] [Indexed: 11/05/2022] Open
Affiliation(s)
- Tiago Gomes Paula
- Department of NeurologyUniversidade Federal de Sao Paulo Sao Paulo Brazil
| | - Thiago Cardoso Vale
- Movement Disorders Unit, Department of Internal MedicineUniversidade Federal de Juiz de Fora Juiz de Fora Brazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of NeurologyUniversidade Federal de São Paulo Sao Paulo Brazil
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19
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Vale TC, Barbosa MT, França Resende EDP, Silva LC, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Caramelli P, Cardoso F. No Correlation Between White Matter Changes and Mild Parkinsonian Signs in Individuals Aged Older Than 75 Years. Mov Disord 2020; 35:1489-1491. [PMID: 32491221 DOI: 10.1002/mds.28120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 05/06/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Thiago Cardoso Vale
- Internal Medicine Department, The Federal University of Juiz de Fora Medical School, Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Research Group, Internal Medicine Department, The Federa University of Minas Gerais, Medical School, Brazil.,Faculty of Medical Sciences of Minas Gerais, Belo Horizonte (MG), Brazil
| | - Elisa de Paula França Resende
- Behavioral and Cognitive Neurology Research Group, Internal Medicine Department, The Federa University of Minas Gerais, Medical School, Brazil
| | - Luciana Costa Silva
- Radiology Service of the Hermes Pardini Institute, Belo Horizonte (MG), Brazil
| | - Débora Palma Maia
- Movement Disorders Unit, Internal Medicine Department, The Federal University of Minas Gerais, Medical School, Brazil
| | | | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Research Group, Internal Medicine Department, The Federa University of Minas Gerais, Medical School, Brazil
| | | | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Internal Medicine Department, The Federa University of Minas Gerais, Medical School, Brazil
| | - Francisco Cardoso
- Movement Disorders Unit, Internal Medicine Department, The Federal University of Minas Gerais, Medical School, Brazil
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20
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Pedroso JL, Vale TC, Braga-Neto P, Dutra LA, França MC, Teive HAG, Barsottini OGP. Acute cerebellar ataxia: differential diagnosis and clinical approach. Arq Neuropsiquiatr 2020; 77:184-193. [PMID: 30970132 DOI: 10.1590/0004-282x20190020] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 12/02/2018] [Indexed: 12/20/2022]
Abstract
Cerebellar ataxia is a common finding in neurological practice and has a wide variety of causes, ranging from the chronic and slowly-progressive cerebellar degenerations to the acute cerebellar lesions due to infarction, edema and hemorrhage, configuring a true neurological emergency. Acute cerebellar ataxia is a syndrome that occurs in less than 72 hours, in previously healthy subjects. Acute ataxia usually results in hospitalization and extensive laboratory investigation. Clinicians are often faced with decisions on the extent and timing of the initial screening tests, particularly to detect treatable causes. The main group of diseases that may cause acute ataxias discussed in this article are: stroke, infectious, toxic, immune-mediated, paraneoplastic, vitamin deficiency, structural lesions and metabolic diseases. This review focuses on the etiologic and diagnostic considerations for acute ataxia.
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Affiliation(s)
- José Luiz Pedroso
- Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil
| | - Thiago Cardoso Vale
- Universidade Federal de Juiz de Fora, Departamento de Clínica Médica, Serviço de Neurologia do Hospital Universitário, Juiz de Fora MG, Brasil
| | - Pedro Braga-Neto
- Universidade Federal do Ceará, Departamento de Medicina Clínica, Divisão de Neurologia, Fortaleza CE, Brasil.,Universidade Estadual do Ceará, Centro de Ciências da Saúde, Fortaleza CE, Brasil
| | - Lívia Almeida Dutra
- Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil.,Faculdade Israelita de Ciências da Saúde Albert Einstein, Hospital Israelita Albert Einstein, São Paulo SP, Brasil
| | | | - Hélio A G Teive
- Universidade Federal do Paraná, Hospital de Clínicas, Departamento de Medicina Interna, Serviço de Neurologia, Setor de Distúrbios do Movimento, Curitiba PR, Brasil
| | - Orlando G P Barsottini
- Universidade Federal de São Paulo, Departamento de Neurologia e Neurocirurgia, Unidade de Neurologia Geral e de Ataxias, São Paulo SP, Brasil
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21
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Freitas JL, Vale TC, Barsottini OGP, Pedroso JL. Expanding the Phenotype of Dystonia-Deafness Syndrome Caused by ACTB Gene Mutation. Mov Disord Clin Pract 2019; 7:86-87. [PMID: 31970217 DOI: 10.1002/mdc3.12854] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/23/2019] [Accepted: 10/06/2019] [Indexed: 11/09/2022] Open
Affiliation(s)
- Julian Letícia Freitas
- Division of General Neurology and Ataxia Unit, Department of Neurology Universidade Federal de São Paulo São Paulo Brazil
| | - Thiago Cardoso Vale
- Movement Disorders Unit, Service of Neurology University Hospital, Universidade Federal de Juiz de Fora Juiz de Fora Brazil
| | - Orlando G P Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology Universidade Federal de São Paulo São Paulo Brazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology Universidade Federal de São Paulo São Paulo Brazil
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22
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De Oliveira DS, Pinto BD, Vale TC, Pires LA. Stroke after lung biopsy. Pract Neurol 2019; 19:543-544. [PMID: 31273076 DOI: 10.1136/practneurol-2019-002230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2019] [Indexed: 11/03/2022]
Affiliation(s)
| | - Bruna Duarte Pinto
- Serviço de Neurologia, Hospital Universitário da Universidade Federal, Juiz de Fora, Brazil
| | - Thiago Cardoso Vale
- Serviço de Neurologia, Hospital Universitário da Universidade Federal, Juiz de Fora, Brazil
| | - Leopoldo Antônio Pires
- Serviço de Neurologia, Hospital Universitário da Universidade Federal, Juiz de Fora, Brazil
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23
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Rezende Filho FM, Vale TC, Pedroso JL, Braga-Neto P, Barsottini OG. Facial grimacing and clinical correlates in spinocerebellar ataxia type 3. J Neurol Sci 2019; 397:138-140. [PMID: 30616057 DOI: 10.1016/j.jns.2019.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 12/27/2018] [Accepted: 01/01/2019] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Spinocerebellar ataxia type 3 (SCA3), also known as Machado-Joseph disease, is the most common spinocerebellar ataxia (SCA) worldwide. SCA3 presents with cerebellar ataxia in association with pyramidal signs, peripheral amyotrophy, nystagmus, ophthalmoparesis, fasciculations of the face and tongue, dystonia and parkinsonism. Oromandibular dystonia (OMD) with facial grimacing (FG) in SCA3 has seldom been reported in the literature and in series of SCA3 patients. METHODS We evaluated 104 patients with SCA (59 patients with SCA3, 20 with SCA2, 20 with SCA7 and 5 with SCA6) and assessed dystonia frequency and types. RESULTS Thirteen cases of SCA3, one of SCA2 and two of SCA7 had dystonia. OMD in the form of FG was present in seven SCA3 patients (11.9%). Patients with FG were significantly younger, had earlier disease onset and a significantly higher CAG repetition length when compared to the SCA3 sample. Parkinsonism, dysphagia and pyramidal signs were significantly more frequent in the FG group than the non-FG group of the SCA3 sample. CONCLUSION Patients with SCA3 presenting with FG are younger, with earlier disease onset and higher CAG repetition length. They present with parkinsonism, dysphagia and pyramidal signs more frequently than SCA3 patients without FG.
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Affiliation(s)
- Flávio Moura Rezende Filho
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
| | - Thiago Cardoso Vale
- Movement Disorders Unit, Neurology Service, Hospital Universitário, Departamento de Clínica Médica da Universidade Federal de Juiz de Fora (MG), Brazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil.
| | - Pedro Braga-Neto
- Division of Neurology, Department of Clinical Medicine, Universidade Federal do Ceará, Brazil; Center of Health Sciences, Universidade Estadual do Ceará, Brazil
| | - Orlando G Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
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24
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Vale TC, Barbosa MT, Resende EDPF, Maia DP, Cunningham MCQ, Guimarães HC, Machado JCB, Teixeira AL, Cardoso F, Caramelli P. Parkinsonism in a population-based study of individuals aged 75+ years: The Pietà study. Parkinsonism Relat Disord 2018; 56:76-81. [PMID: 29934195 DOI: 10.1016/j.parkreldis.2018.06.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 06/05/2018] [Accepted: 06/18/2018] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Parkinsonism is one of the most prevalent neurological syndromes in the elderly. There are only a few epidemiological studies focusing on parkinsonism in oldest-old individuals, particularly in Latin America. This study aims to investigate the prevalence and characteristics of parkinsonism in subjects aged 75 + years living in the community. METHODS The Pietà study is a population-based investigation on brain aging conducted in Caeté, southeast Brazil. A sample composed of 610 community-dwelling individuals aged 75 + years (48.7% of the total population within this age range) underwent clinical, neurological, cognitive and functional assessments. RESULTS The sample comprised mostly women (61.5%), with mean age of 83.3 years and mean schooling of 2.5 years. Parkinsonism was identified in 65 subjects (crude prevalence = 10.7%). Parkinson's disease, Parkinsonism + dementia syndrome, drug-induced parkinsonism, vascular parkinsonism and Lewy-body dementia were identified in, respectively, 19 (29.2%), 19 (29.2%), 8 (12.3%), 4 (6.1%) and 1 (1.5%) subjects. In 14 individuals (21.5%), the etiology of parkinsonism could not be determined. The most important vascular risk factor was hypertension (64.6%). Cognitive evaluation disclosed dementia in 37 (56.9%) subjects. Mean Pfeffer's functional activities questionnaire score was 12.2 points and 22 (33.8%) subjects were impaired in basic activities of daily living. CONCLUSION Parkinsonism was common in this oldest-old population, being associated with dementia and vascular risk factors, particularly hypertension. Different confounders, such as concomitant dementia and exposure to anti-dopaminergic drugs, were present in this population, challenging the definition of causes of parkinsonism.
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Affiliation(s)
- Thiago Cardoso Vale
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Juiz de Fora (MG), Brazil
| | - Maira Tonidandel Barbosa
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil; Faculdade de Ciências Médicas de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Elisa de Paula França Resende
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Débora Palma Maia
- Movement Disorders Unit, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Mauro César Quintão Cunningham
- Movement Disorders Unit, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Henrique Cerqueira Guimarães
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | | | - Antônio Lucio Teixeira
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Francisco Cardoso
- Movement Disorders Unit, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais (MG), Brazil.
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25
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Godeiro Junior CDO, Vale TC, Afonso CODM, Kok F, Pedroso JL, Barsottini OG. Progressive Myoclonic Epilepsy Type 8 Due to CERS1 Deficiency: A Novel Mutation with Prominent Ataxia. Mov Disord Clin Pract 2018; 5:330-332. [PMID: 30800706 PMCID: PMC6336183 DOI: 10.1002/mdc3.12610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Revised: 01/18/2018] [Accepted: 02/19/2018] [Indexed: 12/17/2022] Open
Abstract
View Supplementary Video 1
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Affiliation(s)
| | - Thiago Cardoso Vale
- Department of Internal MedicineUniversidade Federal de Juiz de ForaJuiz de ForaMGBrazil
| | | | - Fernando Kok
- Neurogenetics Unit, Department of NeurologyUniversity of São Paulo School of MedicineSao PauloSPBrazil
- Mendelics Genomic AnalysisSao PauloSPBrazil
| | - José Luiz Pedroso
- Department of NeurologyUniversidade Federal de São PauloSao PauloSPBrazil
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26
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Pedroso JL, Vale TC, Gama MTD, Ribas G, Kristochik JCG, Germiniani FMB, Fink MCDDS, Oliveira ACPD, Teive HAG, Barsottini OG. Cerebellar degeneration and progressive ataxia associated with HIV-virus infection. Parkinsonism Relat Disord 2018; 54:95-98. [PMID: 29643006 DOI: 10.1016/j.parkreldis.2018.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/28/2018] [Accepted: 04/02/2018] [Indexed: 12/13/2022]
Abstract
INTRODUCTION The spectrum of neurologic disorders associated with HIV infection is very broad, resulting from direct virus invasion, opportunistic infections, malignancies and toxic effects of drugs. METHODS Among a large cohort of ataxia patients (N = 1050) evaluated between 2008 and 2017, we detected four patients with HIV-infection who developed a pure progressive cerebellar ataxia syndrome combined with cerebellar atrophy. RESULTS Adverse drug effects, opportunistic infections and malignancies as well as immune-reconstitution syndrome were ruled out based on history and laboratory data. The exact pathophysiological mechanisms of ataxia in HIV patients is not very clear, but seems to be immune-mediated or a direct neurotoxic virus effect leading to apoptosis of Purkinje and granular cells. CONCLUSION HIV infection should be investigated in adult patients with undetermined sporadic progressive pure ataxia with cerebellar atrophy.
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Affiliation(s)
- José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil.
| | - Thiago Cardoso Vale
- Movement Disorders Unit, Neurology Service, University Hospital, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Maria Thereza Drumond Gama
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
| | - Gustavo Ribas
- Movement Disorders Unit, Department of Neurology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Julio C G Kristochik
- Movement Disorders Unit, Department of Neurology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Francisco M B Germiniani
- Movement Disorders Unit, Department of Neurology, Universidade Federal do Paraná, Curitiba, Brazil
| | | | | | - Helio A G Teive
- Movement Disorders Unit, Department of Neurology, Universidade Federal do Paraná, Curitiba, Brazil
| | - Orlando G Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
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27
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Barcellos I, Vale TC, Pedroso JL, Tibana LAT, Barsottini OGP. Tractography study in a patient with hemidystonia-hemiatrophy syndrome. Mov Disord Clin Pract 2018; 5:200-202. [PMID: 30746400 PMCID: PMC6336368 DOI: 10.1002/mdc3.12579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 11/20/2017] [Accepted: 11/28/2017] [Indexed: 11/11/2022] Open
Abstract
View Supplementary Video 1
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Affiliation(s)
- Igor Barcellos
- Department of NeurologyHospital Universitário CajuruPontifícia Universidade Católica do ParanáCuritiba PRBrazil
| | - Thiago Cardoso Vale
- Department of Internal MedicineUniversidade Federal de Juiz de ForaJuiz de Fora, MGBrazil
| | - José Luiz Pedroso
- Department of NeurologyAtaxia UnitUniversidade Federal de São PauloSão Paulo, SPBrazil
| | - Luis Antônio Tobaru Tibana
- Department of Diagnostic ImagingNeuroradiology SectorUniversidade Federal de São PauloSão Paulo, SPBrazil
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Pedroso JL, Vale TC, Bueno FL, Marussi VHR, Amaral LLFD, França MC, Barsottini OG. SPG7 with parkinsonism responsive to levodopa and dopaminergic deficit. Parkinsonism Relat Disord 2018; 47:88-90. [DOI: 10.1016/j.parkreldis.2017.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 11/08/2017] [Accepted: 12/06/2017] [Indexed: 10/18/2022]
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Vale TC, Oliveira MM, de Sousa-Pereira SR, Lambertucci JR, Silva Gusmão SN. Diffuse pseudotumoral cerebral Schistosomiasis mansoni: a new form of presentation. Arq Bras Neurocir 2018. [DOI: 10.1055/s-0038-1625637] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractWe describe two cases of cerebral schistosomiasis mansoni with multiple pseudotumoral lesions diagnosed by stereotactic brain biopsy. Both patients presented with seizures and one with left visual impairment. Imaging techniques revealed multiple brain lesions involving cerebral parenchyma, pons, cerebellum and thalamus. Brain histopathologic specimens of the patients showed multiple schistosomal granulomas in distinct evolutive phases. All patients presented good clinical response to treatment and reversion of the brain lesions. This new form of neuroschistosomiasis must be considered by those who work in the endemic area for Schistosoma mansoni.
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Silva RAE, Souza TAPD, Vale TC. Multiple sporadic cerebral cavernous malformations. Arq Neuropsiquiatr 2017; 75:895. [PMID: 29236895 DOI: 10.1590/0004-282x20170154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 09/05/2017] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Thiago Cardoso Vale
- Universidade Federal de Juiz de Fora, Faculdade de Medicina, Hospital Universitário, Unidade de Distúrbios do Movimento, Serviço de Neurologia, Juiz de Fora MG, Brasil
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Pedroso JL, Vale TC, Barsottini OG, Oliveira ASB, Espay AJ. Perioral and tongue fasciculations in Kennedy’s disease. Neurol Sci 2017; 39:777-779. [DOI: 10.1007/s10072-017-3170-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 10/25/2017] [Indexed: 11/30/2022]
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Rocha E, Vale TC, Kok F, Pedroso JL, Barsottini OG. Teaching Neuro Images: Spinocerebellar ataxia type 3 presenting with a cock-walk gait phenotype. Neurology 2017; 89:e192. [PMID: 28993536 DOI: 10.1212/wnl.0000000000004497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Eva Rocha
- From the Department of Neurology (E.R., J.L.P., O.G.B.), Universidade Federal de São Paulo; Department of Internal Medicine (T.C.V.), Universidade Federal de Juiz de Fora; and Neurogenetics Unit, Department of Neurology (F.K.), and Center for Research of Human Genome and Stem Cell, Biosciences Institute (F.K.), University of São Paulo School of Medicine, Brazil
| | - Thiago Cardoso Vale
- From the Department of Neurology (E.R., J.L.P., O.G.B.), Universidade Federal de São Paulo; Department of Internal Medicine (T.C.V.), Universidade Federal de Juiz de Fora; and Neurogenetics Unit, Department of Neurology (F.K.), and Center for Research of Human Genome and Stem Cell, Biosciences Institute (F.K.), University of São Paulo School of Medicine, Brazil
| | - Fernando Kok
- From the Department of Neurology (E.R., J.L.P., O.G.B.), Universidade Federal de São Paulo; Department of Internal Medicine (T.C.V.), Universidade Federal de Juiz de Fora; and Neurogenetics Unit, Department of Neurology (F.K.), and Center for Research of Human Genome and Stem Cell, Biosciences Institute (F.K.), University of São Paulo School of Medicine, Brazil
| | - José Luiz Pedroso
- From the Department of Neurology (E.R., J.L.P., O.G.B.), Universidade Federal de São Paulo; Department of Internal Medicine (T.C.V.), Universidade Federal de Juiz de Fora; and Neurogenetics Unit, Department of Neurology (F.K.), and Center for Research of Human Genome and Stem Cell, Biosciences Institute (F.K.), University of São Paulo School of Medicine, Brazil.
| | - Orlando G Barsottini
- From the Department of Neurology (E.R., J.L.P., O.G.B.), Universidade Federal de São Paulo; Department of Internal Medicine (T.C.V.), Universidade Federal de Juiz de Fora; and Neurogenetics Unit, Department of Neurology (F.K.), and Center for Research of Human Genome and Stem Cell, Biosciences Institute (F.K.), University of São Paulo School of Medicine, Brazil
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Vale TC, de Lima Pinto FC, Pedroso JL, Alves Dos Reis M, Batista IR, Affonseca Bressan R, Magalhães Rivero RL, Mendonça RA, Barsottini OG. Case 241: Hemiparkinsonism- Hemiatrophy-SPECT with 99mTc TRODAT-1 and Muscle MR Imaging Abnormalities. Radiology 2017; 283:613-619. [PMID: 28418820 DOI: 10.1148/radiol.2017151717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
History A 43-year-old right-handed man presented with a history of progressive mild left-sided weakness and slowness of movements. Symptoms began 4 years earlier, and the patient noticed a progressive decline in his daily routine due to gait difficulties in the past year. There was no history of head trauma, surgery, drug therapy, smoking, or alcohol abuse, nor was there any relevant family history. Examination revealed normal cognition (29 of 30 points on the Mini-Mental State Examination and 27 of 30 points on the Montreal Cognitive Assessment) and normal cerebellar, sensory, cranial nerve, and autonomic function. There was mild left-sided weakness involving the upper and lower limbs (medical research council graded muscle strength as 4+ out of 5) that was associated with facial hypomimia and a rigid akinetic syndrome only in the patient's left hemibody (Unified Parkinson's Disease Rating Scale [UPDRS] part III [motor examination], 23 out of 52 points). Mild atrophy in the left upper and lower limbs without pain, swelling, or skin lesions was noted at physical examination. Routine blood chemistry was normal, as were serum creatine kinase and aldolase levels and thyroid, hepatic, and renal function. T1- and T2-weighted, fluid-attenuated inversion recovery, diffusion- and perfusion-weighted, and contrast material-enhanced brain magnetic resonance (MR) imaging results were normal, without basal ganglia hyperintensity, lacunae, calcification, or heavy metal deposits. Muscle MR imaging and single photon emission computed tomography (SPECT) with technetium 99m (99mTc) tropane dopamine transporter (TRODAT)-1 were performed for further evaluation. This patient received levodopa and benserazide (200 and 50 mg, respectively) four times a day and amantadine (100 mg) three times a day without adequate improvement (UPDRS score decreased from 23 to 20 points).
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Affiliation(s)
- Thiago Cardoso Vale
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
| | - Flávia Cristina de Lima Pinto
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
| | - José Luiz Pedroso
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
| | - Marília Alves Dos Reis
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
| | - Ilza Rosa Batista
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
| | - Rodrigo Affonseca Bressan
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
| | - René Leandro Magalhães Rivero
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
| | - Renato Adam Mendonça
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
| | - Orlando G Barsottini
- From the Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil (T.C.V.); Department of Neurology (F.C.d.L.P., J.L.P., O.G.B.) and Department of Psychiatry, Laboratório Interdisciplinar de Neurociências Clínicas (LiNC) (M.A.d.R., I.R.B., R.A.B.), Universidade Federal de São Paulo, R. Sena Madureira 1500, Vila Clementino, São Paulo, SP 04021-001, Brazil; and Delboni Auriemo, Diagnósticos da América SA, São Paulo, Brazil (R.L.M.R., R.A.M.)
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Vale TC, Pedroso JL, Dutra LA, Azevedo L, Filho LHP, Prado LBF, Hoftberger R, Prado GF, Barsottini OG. Morvan syndrome as a paraneoplastic disorder of thymoma with anti-CASPR2 antibodies. Lancet 2017; 389:1367-1368. [PMID: 28379152 DOI: 10.1016/s0140-6736(16)31459-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 06/17/2016] [Accepted: 08/17/2016] [Indexed: 12/01/2022]
Affiliation(s)
- Thiago Cardoso Vale
- Movement Disorders Unit, Neurology Service, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil.
| | - Lívia Almeida Dutra
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
| | - Lyamara Azevedo
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
| | | | - Lucila B F Prado
- Sleep Disorders Center, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
| | | | - Gilmar F Prado
- Sleep Disorders Center, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
| | - Orlando G Barsottini
- Division of General Neurology and Ataxia Unit, Department of Neurology and Neurosurgery, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo, Brazil
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Cardoso Vale T, de Lima Pinto FC, Pedroso JL, Alves dos Reis M, Batista IR, Affonseca Bressan R, Magalhães Rivero RL, Mendonça RA, Povoas Barsottini OG. Case 241. Radiology 2017; 282:289-292. [DOI: 10.1148/radiol.2016151718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pedroso JL, Vale TC, Barsottini OGP. Are Gait Stereotypies a Marker for Neurodegeneration in Down Syndrome? A Prospective Observation. Tremor Other Hyperkinet Mov (N Y) 2016; 6:403. [PMID: 27761302 PMCID: PMC5039946 DOI: 10.7916/d85d8s1q] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/22/2016] [Indexed: 11/11/2022] Open
Affiliation(s)
- José Luiz Pedroso
- Department of Neurology, Division of General Neurology and Ataxia Unit, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Thiago Cardoso Vale
- Department of Internal Medicine, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil
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Vale TC, Pedroso JL, Knobel M, Knobel E. Late-Onset Psychogenic Chronic Phonic-Tics. Tremor Other Hyperkinet Mov (N Y) 2016; 6:387. [PMID: 27375961 PMCID: PMC4925920 DOI: 10.7916/d88s4pww] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2016] [Accepted: 04/20/2016] [Indexed: 12/01/2022]
Abstract
Background Tics beginning in late adulthood often have an identifiable etiology. Psychogenic tics with onset around 60 years of age are rarely described in the literature. Case report A 67-year-old female had experienced phonic tics for 8 years. Episodes occurred without premonitory sensations and precipitant factors, and she could not suppress them. She had no history of childhood tic disorder, and secondary causes of tics were excluded. She was diagnosed with psychogenic tics and treated with quetiapine with mild improvement. Discussion When physicians are faced with no identifiable cause of tics combined with certain clinical clues, a psychogenic disorder must be suspected.
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Affiliation(s)
- Thiago Cardoso Vale
- Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | | | - Marcos Knobel
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
| | - Elias Knobel
- Hospital Israelita Albert Einstein, São Paulo, SP, Brazil
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Affiliation(s)
- José Luiz Pedroso
- 1 Ataxia Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | - Thiago Cardoso Vale
- 2 Movement Disorders Unit, Neurology Service, Department of Internal Medicine, Federal University of Juiz de Fora School of Medicine, Juiz de Fora, MG, Brazil
| | - Fernando Freua
- 3 Neurogenetics Unit, Department of Neurology, University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | - Orlando G P Barsottini
- 1 Ataxia Unit, Department of Neurology and Neurosurgery, Federal University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | - Fernando Kok
- 3 Neurogenetics Unit, Department of Neurology, University of São Paulo School of Medicine, São Paulo, SP, Brazil 4 Mendelics Genomic Analysis, São Paulo, SP, Brazil
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Vale TC, Fernandes do Prado LB, do Prado GF, Povoas Barsottini OG, Pedroso JL. Rapid Eye Movement Sleep Behavior Disorder in Paraneoplastic Cerebellar Degeneration: Improvement with Immunotherapy. Sleep 2016; 39:117-20. [PMID: 26414894 DOI: 10.5665/sleep.5330] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/30/2015] [Indexed: 12/29/2022] Open
Abstract
STUDY OBJECTIVES To report two female patients with paraneoplastic cerebellar degeneration (PCD) related to breast cancer that presented with rapid eye movement-sleep behavior disorder (RBD) and improved sleep symptoms with immunotherapy. METHODS The two patients were evaluated through clinical scale and polysomnography before and after therapy with intravenous immunoglobulin. RESULTS RBD was successfully treated with immunotherapy in both patients. Score on the RBD screening questionnaire dropped from 10 to 1 or 0, allied with the normalization of polysomnographic findings. CONCLUSIONS A marked improvement in RBD after immunotherapy in PCD raises the hypothesis that secondary RBD may be an immune-mediated sleep disorder.
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Affiliation(s)
- Thiago Cardoso Vale
- Movement Disorders Unit, Neurology Service, University Hospital. Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | | | - Gilmar Fernandes do Prado
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal São Paulo, São Paulo, Brazil
| | | | - José Luiz Pedroso
- Division of General Neurology and Ataxia Unit, Department of Neurology, Universidade Federal São Paulo, São Paulo, Brazil
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Vale TC, Pedroso JL, Alquéres RA, Dutra LA, Barsottini OGP. Spontaneous downbeat nystagmus as a clue for the diagnosis of ataxia associated with anti-GAD antibodies. J Neurol Sci 2015; 359:21-3. [DOI: 10.1016/j.jns.2015.10.024] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/27/2015] [Accepted: 10/12/2015] [Indexed: 10/22/2022]
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de Assis Franco I, Teixeira da Rocha E, Chaves de Resende HA, Moura da Silva Guércio N, Pinto MP, Pires LA, Vale TC. Mystery Case: Lafora periodic acid-Schiff inclusion bodies. Neurology 2015; 85:e130-1. [PMID: 26503590 DOI: 10.1212/wnl.0000000000002054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Igor de Assis Franco
- From the Neurology Service (I.d.A.F., E.T.d.R., H.A.C.d.R., M.P.P., L.A.P., T.C.V.) and Pathology Service (N.M.d.S.G.), University Hospital, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Eliza Teixeira da Rocha
- From the Neurology Service (I.d.A.F., E.T.d.R., H.A.C.d.R., M.P.P., L.A.P., T.C.V.) and Pathology Service (N.M.d.S.G.), University Hospital, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Hugo Almeida Chaves de Resende
- From the Neurology Service (I.d.A.F., E.T.d.R., H.A.C.d.R., M.P.P., L.A.P., T.C.V.) and Pathology Service (N.M.d.S.G.), University Hospital, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Nathália Moura da Silva Guércio
- From the Neurology Service (I.d.A.F., E.T.d.R., H.A.C.d.R., M.P.P., L.A.P., T.C.V.) and Pathology Service (N.M.d.S.G.), University Hospital, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Moisés Pereira Pinto
- From the Neurology Service (I.d.A.F., E.T.d.R., H.A.C.d.R., M.P.P., L.A.P., T.C.V.) and Pathology Service (N.M.d.S.G.), University Hospital, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Leopoldo Antônio Pires
- From the Neurology Service (I.d.A.F., E.T.d.R., H.A.C.d.R., M.P.P., L.A.P., T.C.V.) and Pathology Service (N.M.d.S.G.), University Hospital, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Thiago Cardoso Vale
- From the Neurology Service (I.d.A.F., E.T.d.R., H.A.C.d.R., M.P.P., L.A.P., T.C.V.) and Pathology Service (N.M.d.S.G.), University Hospital, Department of Internal Medicine, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil.
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Abstract
The original descriptions of chorea date from the Middle Ages, when an epidemic of "dancing mania" swept throughout Europe. The condition was initially considered a curse sent by a saint, but was named "Saint Vitus's dance" because afflicted individuals were cured if they touched churches storing Saint Vitus's relics. Paracelsus coined the term chorea Sancti Viti and recognized different forms of chorea (imaginativa, lasciva, and naturalis). In the 17th century, Thomas Sydenham provided an accurate description of what he termed chorea minor. He also described rheumatic fever but did not associate it with chorea. It was only in 1850 that See established a relationship between chorea and rheumatic disease. A connection with cardiac involvement was soon recognized and in 1866 Roger postulated that chorea, arthritis, and heart disease had a common cause. The last quarter of the 19th century is marked by the works of Jean-Martin Charcot, Silas Weir Mitchell, William Osler, and William Richard Gowers, all of paramount importance in the refinement of the definition of chorea, its causes, and differential diagnosis. In 1841, Charles Oscar Waters gave a concise account of a syndrome, likely to be Huntington's disease (HD), later described further by George Huntington and named after him. In 1955, the Venezuelan physician Americo Negrette published a book describing communities in the State of Zulia in Venezuela, with unusual numbers of individuals with chorea. Negrette's works culminated in the creation of the Venezuela project and the subsequent discovery of seminal findings in HD. We review the historical facts and outstanding physicians that mark both HD and Sydenham's chorea's history in various sections.
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Affiliation(s)
- Thiago Cardoso Vale
- Movement Disorders Clinic, Medical School, Universidade Federal de Juiz de Fora, Juiz de Fora, Brazil
| | - Francisco Cardoso
- Movement Disorders Clinic, Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Vale TC, Caramelli P, Cardoso F. Clinicoradiological comparison between vascular parkinsonism and Parkinson's disease. J Neurol Neurosurg Psychiatry 2015; 86:547-53. [PMID: 25006209 DOI: 10.1136/jnnp-2014-307867] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Accepted: 06/19/2014] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare the clinical and radiological features of vascular parkinsonism (VP) and Parkinson's disease (PD). METHODS Cross-sectional study where 15 patients with VP (8 (53.3%) men; aged 75.7 ± 10.4 years) and 30 patients with PD (17 (56.7%) men; aged 67.3 ± 7.5 years) underwent motor and cognitive evaluation and brain MRI. RESULTS Patients with VP were, on average, 8.4 years older (p = 0.004); all had arterial hypertension. They presented with a sudden onset of parkinsonism (80%) and a rapidly progressive clinical course (53.3%). Predominant lower body parkinsonism (p<0.001), postural instability (p=0.003) with freezing of gait (p<0.001) and falls (p<0.001), urinary incontinence (p < 0.001) and pyramidal signs (p<0.001) were more common in patients with VP. Movement Disorders Society's Unified PD Rating Scale (MDS-UPDRS) scores were higher in patients with VP (p=0.005 in 'OFF' state and p<0.001 in 'ON' state). They had greater cognitive impairment and 12 (80%) fulfilled diagnostic criteria for probable vascular dementia. Most patients with VP had brain MRI changes: multiple lacunar infarcts (66.7%) or extensive white matter disease (26.7%). CONCLUSIONS VP can be clinically distinguished from PD based on sudden onset of parkinsonism at an older age, characterised by lower body predominance, urinary incontinence, pyramidal signs, postural instability with freezing of gait and falls, and dementia.
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Affiliation(s)
- Thiago Cardoso Vale
- Department of Neurology Service and Internal Medicine, Faculty of Medicine, University Hospital, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - Paulo Caramelli
- Cognitive and Behavioral Neurology Unit, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Francisco Cardoso
- Movement Disorders Unit, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Vale TC, Pedroso JL, Barsottini OG, Lees AJ. A Brazilian Football Player Still on the Pitch After 10 Years of Parkinson's Disease with Severe Freezing of Gait. Mov Disord Clin Pract 2015; 2:43-44. [PMID: 30713875 PMCID: PMC6353400 DOI: 10.1002/mdc3.12110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Revised: 10/20/2014] [Accepted: 10/22/2014] [Indexed: 11/09/2022] Open
Affiliation(s)
- Thiago Cardoso Vale
- Movement Disorders UnitNeurology ServiceUniversity HospitalJuiz de ForaMinas GeraisBrazil
- Department of Internal MedicineFaculty of MedicineFederal University of Juiz de Fora (UFJF)Juiz de ForaMinas GeraisBrazil
| | - José Luiz Pedroso
- Division of General Neurology and Ataxia UnitNeurology DepartmentFederal University of São PauloSão PauloBrazil
| | - Orlando Graziani Barsottini
- Division of General Neurology and Ataxia UnitNeurology DepartmentFederal University of São PauloSão PauloBrazil
| | - Andrew John Lees
- The National Hospital for Neurology and NeurosurgeryLondonUnited Kingdom
- Reta Lila Weston Institute of Neurological StudiesUniversity College LondonLondonUnited Kingdom
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Vale TC, Fernandes LC, Caramelli P. Charles Bonnet syndrome: characteristics of its visual hallucinations and differential diagnosis. Arq Neuropsiquiatr 2014; 72:333-6. [PMID: 24863507 DOI: 10.1590/0004-282x20140015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 01/19/2014] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To present an eight-case serie of patients with Charles Bonnet syndrome (CBS). METHOD All patients were initially evaluated by an ophthalmologist and then submitted to a neurologic evaluation with exclusion of alternative psychiatric and neurologic diagnoses. RESULTS Five patients were male (62.5%) and the mean age was 52.3+16.0 years. Two patients suffered from severe myopia and glaucoma, three had retinitis pigmentosa, one had anterior ischemic optic neuropathy, one had age-related macular degeneration and one had toxoplasmic retinochoroiditis. Mean visual acuity in the right eye was 1,12 logMAR and in the left eye 0.57 logMAR. A mean delay of 41.7 months occurred until diagnosis. All hallucinations were complexes and mostly ocurred on a weekly-basis (62.5%) and lasted for seconds (87.5%). CONCLUSIONS Physicians who care for low vision patients should be aware of CBS and appropriately diagnose its hallucinations after exclusion of psychiatric and neurologic diseases.
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Affiliation(s)
- Thiago Cardoso Vale
- Serviço de Neurologia, Hospital Universitário, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | | | - Paulo Caramelli
- Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Vale TC, Silva RAE, Cunningham MCQES, Maia DP, Camargos ST, Cardoso F. Opsoclonus-myoclonus-ataxia syndrome in an AIDS patient. Einstein (Sao Paulo) 2014; 11:533-4. [PMID: 24488398 PMCID: PMC4880396 DOI: 10.1590/s1679-45082013000400023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Accepted: 04/24/2013] [Indexed: 11/22/2022] Open
Abstract
We report the case of a 38-year-old woman with AIDS who developed opsoclonus-myoclonus-ataxia syndrome during a period different from other cases reported in literature. Opsoclonus-myoclonus-ataxia syndrome had already been reported as the initial neurological presentation of AIDS, as well as at the time of HIV-seroconversion and immune reconstitution syndrome. Our case is unique since the patient had an elevated CD4 count and negative viral load in the period when the opsoclonus-myoclonus-ataxia syndrome occurred.
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Cruzeiro MM, Resende HACD, Franco IDA, Pires LA, Vale TC. An indolent headache revealing a megadolicho-diffuse vascular malformation. Arq Neuropsiquiatr 2014; 72:741. [PMID: 25252242 DOI: 10.1590/0004-282x20140103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/17/2014] [Indexed: 11/22/2022]
Affiliation(s)
- Marcelo Maroco Cruzeiro
- Departamento de Clínica Médica, Hospital Universitário, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Hugo Almeida Chaves de Resende
- Departamento de Clínica Médica, Hospital Universitário, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Igor de Assis Franco
- Departamento de Clínica Médica, Hospital Universitário, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Leopoldo Antônio Pires
- Departamento de Clínica Médica, Hospital Universitário, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
| | - Thiago Cardoso Vale
- Departamento de Clínica Médica, Hospital Universitário, Faculdade de Medicina, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brazil
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Amâncio FF, Pereira MA, Iani FCDM, D'anunciação L, de Almeida JLC, Soares JAS, Ferraz ML, Vale TC, Lambertucci JR, Carneiro M. Fatal outcome of infection by dengue 4 in a patient with thrombocytopenic purpura as a comorbid condition in Brazil. Rev Inst Med Trop Sao Paulo 2014; 56:267-70. [PMID: 24879007 PMCID: PMC4085867 DOI: 10.1590/s0036-46652014000300014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 10/02/2013] [Indexed: 11/21/2022] Open
Abstract
Dengue is currently a major public-health problem. Dengue virus (DENV) is
classified into four distinct serotypes, DENV 1-4. After 28 years of absence, DENV-4
was again detected in Brazil in 2010 in Roraima State, and one year later, the virus
was identified in the northern Brazilian states of Amazonas and Pará, followed by Rio
de Janeiro and São Paulo. In Minas Gerais, the first confirmed case of DENV-4
occurred in the municipality of Frutal in 2011 and has now been isolated from a
growing number of patients. Although DENV-2 is associated with the highest risk of
severe forms of the disease and death due to the infection, DENV-4 has also been
associated with severe forms of the disease and an increasing risk of hemorrhagic
manifestations. Herein, the first fatal case of confirmed DENV-4 in Brazil is
reported. The patient was an 11-year-old girl from the municipality of Montes Claros
in northern Minas Gerais State, Brazil. She had idiopathic thrombocytopenic purpura
as a comorbid condition and presented with a fulminant course of infection, leading
to death due to hemorrhagic complications. Diagnosis was confirmed by detection of
Dengue-specific antibodies using IgM capture enzyme-linked immunosorbent assay and
semi-nested RT-PCR. Primary care physicians and other health-care
providers should bear in mind that DENV-4 can also result in severe forms of the
disease and lead to hemorrhagic complications and death, mainly when dengue infection
is associated with coexisting conditions.
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Affiliation(s)
- Frederico Figueiredo Amâncio
- Curso de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | | | | | | | | | | | - Thiago Cardoso Vale
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - José Roberto Lambertucci
- Curso de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Mariângela Carneiro
- Curso de Pós-Graduação em Ciências da Saúde: Infectologia e Medicina Tropical, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
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Vale TC, Santos DMB, Maciel RO, Cardoso F, Happle R. Photoletter to the editor: A neurocutaneous rarity: phacomatosis pigmentokeratotica. J Dermatol Case Rep 2014; 8:58-9. [PMID: 25024780 DOI: 10.3315/jdcr.2014.1174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 11/26/2013] [Indexed: 11/11/2022]
Abstract
Phacomatosis pigmentokeratotica is characterized by the coexistence of nevus sebaceus, papular nevus spilus and associated neurologic abnormalities. We report a case of phacomatosis pigmentokeratotica in a 28-year-old male who presented with palmar-plantar dysesthesia and ipsilateral brain hemiatrophy. As a characteristic neuroimaging finding of the disorder, we found multiple hypointense lesions involving the ipsilateral hemisphere.
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Affiliation(s)
- Thiago Cardoso Vale
- Neurology Division, University Hospital, Faculty of Medicine, Federal University of Juiz de Fora (UFJF), Juiz de Fora, Minas Gerais, Brazil
| | - David Márcio Barbosa Santos
- Neurology Division, University Hospital, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Oliveira Maciel
- Neurology Division, University Hospital, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Francisco Cardoso
- Neurology Division, Department of Internal Medicine, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Rudolf Happle
- Department of Dermatology, Freiburg University Medical Center, Freiburg, Germany
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Vale TC, Vasconcelos LPB, Marques FS, Maia DP, Cardoso F. Hemiballismus secondary to metastatic breast cancer. Neurol Sci 2014; 35:795-6. [PMID: 24504618 DOI: 10.1007/s10072-014-1654-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Accepted: 01/23/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Thiago Cardoso Vale
- Movement Disorders Unit, Neurology Service, Faculty of Medicine, University Hospital, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil,
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