Arquivos de Neuro-Psiquiatria (Sep 2005)
Achados dos potenciais evocados somatossensitivos e motores na mielopatia associada oa HTLV-I Somatosensitive and motor evoked potentials in HTLV-I associated mylopathy
Abstract
Foram estudados 63 pacientes com diagnóstico de paraparesia espástica tropical/ mielopatia associada ao HTLV-I (PET/ MAH) através de potencial evocado somatossensitivo (PESS) e 42 destes pacientes através de potencial evocado motor (PEM). Todos os pacientes apresentaram história clínica típica de MAH e sorologia para HTLV-I confirmada por Western blot. Dos pacientes estudados por PESS 51/63 (81%) alterados em membros inferiores e 11 (17,5%) deles estavam também em membros superiores. Dos pacientes estudados por PEM 37/42 estavam alterados, 34/42 (81%) em membros inferiores e 25/42 (59,5%) em membros superiores. Um alto percentual da amostra apresentou alterações das vias corticoespinhais nos quatro membros ao PEM, e ausência de alterações em membros superiores ao PESS, evidenciando a correlação entre o tempo de condução motora central para membros superiores e a gravidade clínica da PET/ MAH (pThis study investigated 63 patients with HTLV-I associated myelopathy / tropical spastic paraparesis (HAM/ TSP) by somatosensitive evoked potentials (SEPs) and 42 of them by motor evoked potentials (MEP). All the patients had typical clinical history of HAM, serum samples tested positive for antibodies to HTLV-I screened for Particle Aglutination, ELISA and complemented by Western blot test. In patients studied by SEPs of lower limbs 51/63 (81 %) were abnormal and 11 of them (17.5%) were abnormal in upper limbs also. In patients studied by MEP 37/42 were abnormal, 34/42 (81%) in lower limbs and 25/42 (59.5%) in upper limbs. A high percent of the population studied had abnormalities of the corticospinal tracts on the four limbs at the PEM, without abnormalities in upper limbs by SEPs, showing the correlation between central motor conduction time in upper limbs and the clinical severity of HAM/TSP (p< 0.01). It was not found correlation between time of disease and the results of the SEPs and MEP (p=0.69).
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