• JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
  • JoomlaWorks Simple Image Rotator
 
  Bookmark and Share
 
 
Master's Dissertation
DOI
10.11606/D.17.2018.tde-25042018-150422
Document
Author
Full name
Pedro Henrique Marte de Arruda Sampaio
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2017
Supervisor
Committee
Barreira, Amilton Antunes (President)
Freitas, Marcos Raimundo Gomes de
Júnior, Wilson Marques
Takayanagui, Osvaldo Massaiti
Title in Portuguese
Assimetrias no exame neurológico de crianças com síndrome de Guillain-Barré
Keywords in Portuguese
Assimetria
Epidemiologia
Síndrome de Guillain-Barré
Síndrome de Miller Fisher
Abstract in Portuguese
A Síndrome de Guillain-Barré (SGB) é uma neuropatia periférica inflamatória aguda que tem sido definida pelo achado ou história de tetraparesia flácida arreflexa ascendente. Apresentações atípicas podem ser mais frequentes do que tem sido referido na literatura, particularmente na faixa etária infantil. Objetivo: Avaliar dados epidemiológicos e a prevalência de assimetria no exame neurológico em crianças com SGB. Métodos: Foram revisados 40 prontuários de crianças de 0 a 15 anos de idade com o diagnóstico de SGB, atendidas entre janeiro de 2000 e agosto de 2016. Avaliouse a presença de assimetrias no exame neurológico na admissão hospitalar, os desfechos clínicos e as características demográficas e clinico-laboratoriais. Resultados: Dois pacientes apresentaram assimetria no exame neurológico na admissão hospitalar e três pacientes admitidos com tetraparesia simétrica apresentaram um quadro motor assimétrico antes da internação. Uma criança evoluiu para assimetria após ter sido admitida com quadro simétrico. Outros oito casos tinham fraqueza segmentar. A presença de assimetria motora ou fraqueza segmentar se correlacionou com a progressão estática dos sintomas (p=0,004) e observou-se uma tendência desses pacientes serem mais jovens, mas essa diferença não foi significativa (p=0,08). Onze pacientes apresentavam reflexos miotáticos preservados e um paciente exibia hiperreflexia na admissão hospitalar. A maioria dos pacientes foi admitida sem conseguir deambular e, na alta, a maioria deambulava com ou sem apoio. Cinco crianças necessitaram de suporte ventilatório e nenhuma foi a óbito. Conclusão: Uma proporção significativa dos pacientes apresentava quadro motor assimétrico ou segmentar e reflexos miotáticos preservados. Os resultados obtidos delineiam aspectos clínicos atípicos na SGB em crianças e podem ajudar na definição diagnóstica e instituição de tratamento precoce.
Title in English
Neurological asymmetries in children with Guillain-Barré syndrome
Keywords in English
Asymmetry
Epidemiology
Guillain-Barré syndrome
Miller Fisher syndrome
Abstract in English
Guillain-Barré syndrome (GBS) is an acute, inflammatory, peripheral neuropathy that has been being defined as an ascending flaccid tetraparesis. Atypical presentations can be frequent, particularly in children, leading to greater challenges in the diagnosis. Objectives: To analyze the epidemiological data and the prevalence of motor asymmetries in the neurological examination of children with GBS. Methods: A total of 40 medical records were analyzed, of children aged 0 to 15 years old diagnosed with GBS, admitted from January 2000 to August 2016. We evaluated the presence of motor asymmetries at the hospital admission, the clinical outcomes and the demographic and clinic-laboratorial characteristics. Results: Two patients had motor asymmetries at hospital admission and three patients admitted with symmetric tetraparesis had an initial motor asymmetry before admission. One patient progressed to asymmetric tetraparesis after being initially admitted with symmetric weakness. Eight other cases had segmental weakness at admission. Motor asymmetry and segmental weakness correlated with a static progression of symptoms (p=0.004) and these patients tended to be younger, but this difference was not significant (p=0.08). Eleven patients had preserved deep tendon reflexes and one exhibited hyperreflexia at the hospital admission. Most patients were admitted on wheel-chair or bedridden, and at discharge the majority could walk with or without help. Five children required mechanical ventilation and no patient died. Conclusion: A significant proportion of patients had asymmetric or segmental weakness and preserved deep tendon reflexes. Those results show that the so-called atypical clinical findings in children with GBS are not uncommon, and needs to be kept in mind to allow an earlier diagnosis and treatment.
 
WARNING - Viewing this document is conditioned on your acceptance of the following terms of use:
This document is only for private use for research and teaching activities. Reproduction for commercial use is forbidden. This rights cover the whole data about this document as well as its contents. Any uses or copies of this document in whole or in part must include the author's name.
Publishing Date
2018-07-24
 
WARNING: Learn what derived works are clicking here.
All rights of the thesis/dissertation are from the authors
CeTI-SC/STI
Digital Library of Theses and Dissertations of USP. Copyright © 2001-2019. All rights reserved.