Arquivos de neuro-psiquiatria最新文献

Cervical radiculopathy (CR) is a common condition encountered in the general population, usually related to a musculoskeletal degenerative condition. Conventional electroneuromyography (ENMG) consists of nerve conduction studies (NCS) and needle electromyography (EMG), and it is regarded as the most specific diagnostic evaluation in this scenario. Although CR is commonly encountered in clinical practice, ENMG as a diagnostic tool is not often discussed in neurology residency programs. Electromyography has demonstrated modest sensitivity (50-71%) but excellent specificity (approaching 100%) for the diagnosis of CR. It can also provide valuable information about lesion chronicity. In EMG, acute lesions typically present with denervation potentials and reduced recruitment, but with preserved motor unit action potential (MUAP) morphology. In contrast, chronic lesions are characterized by remodeling, with MUAPs showing increased duration, amplitude, and number of phases, in addition to reduced recruitment. The present review aims to provide an overview of the roles of NCS and EMG, while also introducing key terminology commonly encountered in the interpretation of these diagnostic modalities.

We review the contributions of Georges Guinon, an eminent pupil of Professor Jean-Martin Charcot, to the clinical description of Gilles de La Tourette syndrome, including phenomenological definitions and the occurrence of psychiatric findings such as obsessive-compulsive behavior.

Essential tremor (ET) is the most prevalent movement disorder globally, affecting about 1% of the general population and 5% of those aged over 65 years. Characterized by involuntary, rhythmic oscillations, it primarily manifests as postural and kinetic tremors, predominantly in the upper limbs. Genetic studies, neuropathological examinations, neurophysiological assessments, and various neuroimaging techniques have demonstrated functional, neurotransmitter-related, and structural abnormalities within the cerebello-thalamo-cortical circuit. These findings collectively portray ET as a neurodegenerative syndrome with diverse etiologies and clinical manifestations, highlighting the involvement of the cerebellum.

Chronic pain is highly prevalent in frail older adults, resulting in reduced mobility and poor quality of life. However, research on the experience of chronic pain among frail older adults is scarce.To compare the experience of chronic pain among frail, prefrail, and non-frail older adults, and to identify associations involving pain measures and frailty syndrome.We conducted a cross-sectional study with older adults aged ≥ 60 years presenting chronic pain. The participants were recruited by convenience in specialized outpatient services at public hospitals. Frailty syndrome was identified through the frailty phenotype. The experience of pain was compared among the groups, and we conducted a multivariate logistic regression analysis adjusted for covariates.Out of the 135 participants, 36.3% were non-frail, 38.5%, prefrail, and 25.2%, frail. Frail older adults presented severe pain more frequently (p = 0.009) and had worse scores for neuropathic pain (mean: 4.1; 95%CI: 3.2-5.1) and depression associated with chronic pain (mean: 9.7; 95%CI: 7.9-11.5) compared with non-frail older adults (p < 0.001). Moreover, frail older adults presented worse multidimensional pain scores (mean: 59.4; 95%CI: 51.7-67.2) compared with non-frail (p = 0.001) and prefrail older adults (p = 0.017). Frail older adults were 3.5-fold as likely to present neuropathic pain, and they presented a 7-fold higher risk of severe pain than non-frail and prefrail older adults.Frail older adults present severe chronic pain and experience neuropathic pain more frequently. Comprehensive chronic pain assessment and management in this population is critical to achieve active and healthy aging.

Post coronavirus disease (COVID) syndrome is a frequent condition, resulting from the persistence of symptoms or the development of new ones, after 12 weeks of acute severe acute respiratory syndrome coronavirus 2 infection. The impact on sleep was observed worldwide, whether in the acute phase due to the direct effect of the infection or due to changes in patients' circadian cycle imposed by new routines during quarantine, dysfunctional habits, and social isolation.Given the persistence of sleep-related symptoms in patients with long-term COVID syndrome, we decided to follow-up and reassess these patients after 1 year.The present is an observational, longitudinal, and prospective clinical study. The study took place in two stages: the first assessment between October 2020 and September 2021, with reassessment after 1 year. Participants underwent the application of the Geriatric Depression Scale (GDS) or the Beck Inventory, Addenbrooke's Cognitive Examination - Revised (ACE-R) and Mini-Mental State Examination (MMSE). The evaluation of sleep disorders involved a comprehensive clinical history obtained through a structured questionnaire.Of the 46 cases with sleep complaints, 7 refused to return for a new assessment. Thus, 39 patients were included, of which 9 persisted with insomnia (23.07%) and 2 patients persisted with central hypersomnia (5.12%). The persistence of cognitive complaints was also higher in patients with insomnia when compared with those without it (N = 5; 56%, p = 0.001).Given the persistence of patients with insomnia and central hypersomnia, the damage to the central nervous system may be lasting, reinforcing the need for follow-up.