Neurocysticercosis, immune status and immune response.
نویسندگان
چکیده
1. Schmidt FR, Costa FHR, Silva FMLC, et al. Paroxysmal dystonia and neuromyelitis optica. Arq Neuopsquiatr 2012;70:271-272. References levodopa, hydantoin, baclofen, valproate, gabapentin, and neuroleptics were prescribed to her, all of them in progressively increasing doses. These drugs were used singly and in association, all to no or minimal avail. Her neurological examination showed muscle strength IV in all limbs, however every attempt to assess her strength led to worsening of the athetosis-dystonia. Her gait and coordination could not be assessed, since she was severely disabled by the involuntary movements and abnormal posture. There was predominance of flexion and abduction of the arms and legs, which were more pronounced in the fingers and toes (Figure). Sensitivity was normal, as were the cranial nerves. She was prescribed carbamazepine 200 mg/day, with increasing doses up to 600 mg/day within two weeks. Her response was dramatic, and she returned for a new assessment within a week. Although still presenting a degree of dystonia in all four limbs, she could walk unaided and use her both hands for daily activities. Bilateral optical neuritis was developed nine months later. She continued her treatment with carbamazepine, azathioprine, and corticosteroid pulses when required. Three years and four relapses later the patient presents severe visual and motor disability. We believe that this patient spent eight months without proper diagnosis due to the difficulties encountered by all the neurologists involved in her case. As very properly pointed out by Schmidt et al.1, the literature is scarce on NMO bouts manifesting as athetosis-dystonia.
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ورودعنوان ژورنال:
- Arquivos de neuro-psiquiatria
دوره 70 9 شماره
صفحات -
تاریخ انتشار 2012